维奈克拉联合阿扎胞苷治疗复发弥漫大B细胞淋巴瘤继发急性髓系白血病1例

高升; 袁成录

doi:10.13201/j.issn.1004-2806.2022.05.016

维奈克拉联合阿扎胞苷治疗复发弥漫大B细胞淋巴瘤继发急性髓系白血病1例

高升¹,
袁成录^1, ,

- 山东大学齐鲁医院(青岛)血液科(山东青岛，266035)

详细信息

通讯作者: 袁成录，E-mail：18660229187@163.com

中图分类号: R733.4

收稿日期: 2022-03-21

刊出日期: 2022-05-01

Venetoclax and azacitidine combination treatment in a patient with relapsed diffuse large B cell lymphoma and therapy-related acute myeloid leukemia: a case report and literature review

GAO Sheng¹,
YUAN Chenglu^1, ,

- Department of Hematology, Qilu Hospital[Qingdao], Cheeloo College of Medicine, Shandong University, Qingdao, 266035, China

More Information

Corresponding author: YUAN Chenglu, E-mail: 18660229187@163.com

Received Date: 21 March 2022

Publish Date: 01 May 2022

摘要

摘要: 弥漫大B细胞淋巴瘤是最常见的淋巴瘤类型，其一线治疗有效率在70%以上，但仍有30%~40%的患者会发生疾病复发，复发后治疗效果不佳，生存期短。治疗相关急性髓系白血病是一类预后不良的特殊类型急性白血病，多认为与细胞毒性药物的应用相关，其接受急性髓系白血病传统诱导方案疗效欠佳。维奈克拉(Venetoclax)是一类Bcl-2抑制剂，它可以特异性地结合Bcl-2蛋白以修复肿瘤细胞凋亡途径，目前已被证实在老年急性髓系白血病中具有较好的疗效及耐受性，同时其在淋巴瘤中的应用仍在探索中。现我中心应用维奈克拉联合阿扎胞苷治疗1例复发弥漫大B细胞淋巴瘤合并治疗相关急性髓系白血病患者疗效显著，报告如下并复习相关文献。
- 维奈克拉 /
- 弥漫大B细胞淋巴瘤 /
- 治疗相关急性髓系白血病
Abstract: Diffuse large B cell lymphoma is a most common type of lymphoma in which the response rate is above 70%. However, 30 to 40 percent of patients will relapse and face poor treatment effect and short survival. Therapy-related acute myeloid leukemia(t-AML) is a special type of acute leukemia with poor prognosis, which is generally considered to be related to the application of cytotoxic drugs and has low efficacy to traditional chemotherapy of AML. Venetoclax is a Bcl-2 inhibitor, which can specifically bind with Bcl-2 protein to repair tumor cell apoptosis pathway. Currently, it has been proved to have good efficacy and tolerability in treating elderly AML patients, however, its application in lymphoma is still being explored. We recently treated a patient suffered from both diffuse large B cell lymphoma relapse and t-AML with venetoclax combined with azacitidine who finally acquired a significant therapeutic effect. Herein we report this rare case and make a literature review as well.
- venetoclax /
- diffuse large B cell lymphoma /
- therapy-related acute myeloid leukemia

HTML全文

参考文献(14)

[1]	Van Den Neste E, Schmitz N, Mounier N, et al. Outcomes of diffuse large B-cell lymphoma patients relapsing after autologous stem cell transplantation: an analysis of patients included in the CORAL study[J]. Bone Marrow Transplant, 2017, 52(2): 216-221. doi: 10.1038/bmt.2016.213
[2]	Crump M, Neelapu SS, Farooq U, et al. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study[J]. Blood, 2017, 130(16): 1800-1808. doi: 10.1182/blood-2017-03-769620
[3]	Claerhout H, Lierman E, Michaux L, et al. A monocentric retrospective study of 138 therapy-related myeloid neoplasms[J]. Ann Hematol, 2018, 97(12): 2319-2324. doi: 10.1007/s00277-018-3462-y
[4]	余庭玉, 王利. 淋巴瘤治疗后继发急性白血病研究进展[J]. 临床血液学杂志, 2020, 33(9): 664-669. doi: 10.13201/j.issn.1004-2806.2020.09.017
[5]	庞静玲, 吴涛, 白海. 治疗相关性白血病的研究进展[J]. 中国医刊, 2017, 52(12): 36-38. doi: 10.3969/j.issn.1008-1070.2017.12.010
[6]	Leone, Fianchi L, Pagano L, et al. Incidence and susceptibility to therapy-related myeloid neoplasms[J]. Chem Biol Interact, 2010, 184(1-2): 39-45. doi: 10.1016/j.cbi.2009.12.013
[7]	Garner TP, Lopez A, Reyna DE, et al. Progress in targeting the BCL-2 family of proteins[J]. Curr Opin Chem Biol, 2017, 39: 133-142. doi: 10.1016/j.cbpa.2017.06.014
[8]	Dinardo CD, Pratz K, Pullarkat V, et al. Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia[J]. Blood, 2019, 133(1): 7-17. doi: 10.1182/blood-2018-08-868752
[9]	李秋柏, 吴迪. 老年急性髓系白血病诊治进展[J]. 临床血液学杂志, 2021, 34(5): 308-313. doi: 10.13201/j.issn.1004-2806.2021.05.004
[10]	战榕. Bcl-2抑制剂在急性髓系白血病中的研究进展: 第62届美国血液学年会报道[J]. 临床血液学杂志, 2021, 34(5): 298-301. doi: 10.13201/j.issn.1004-2806.2021.05.002
[11]	Otoukesh S, Salhotra A, Marcucci G, et al. The feasibility of venetoclax and decitabine in therapy-related acute myeloid leukemia with concurrent advanced non-hematological malignancies[J]. Leuk Res, 2019, 84: 106196. doi: 10.1016/j.leukres.2019.106196
[12]	Davids MS, Roberts AW, Seymour JF, et al. Phase Ⅰ first-in-human study of venetoclax in patients with relapsed or refractory non-Hodgkin lymphoma[J]. J Clin Oncol, 2017, 35(8): 826-833. doi: 10.1200/JCO.2016.70.4320
[13]	Rutherford SC, Abramson JS, Bartlett NL, et al. Venetoclax with dose-adjusted EPOCH-R as initial therapy for patients with aggressive B-cell lymphoma: a single-arm, multicentre, phase 1 study[J]. Lancet Haematol, 2021, 8(11): e818-e827. doi: 10.1016/S2352-3026(21)00273-8
[14]	Jaeger U, Egle A, Simonitsch-Klupp I, et al. Phase Ⅱ single-arm "window-of-opportunity" study of a combination of obinutuzumab and venetoclax in early relapsed or refractory diffuse large B-cell lymphoma(DLBCL)-first results of the AGMT NHL15B study[J]. Blood, 2020, 136 Suppl 1: 26.