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中国癌症防治杂志

中国癌症防治杂志 ›› 2022, Vol. 14 ›› Issue (5): 528-533.doi: 10.3969/j.issn.1674-5671.2022.05.09

• 临床研究 • 上一篇    下一篇

维奈克拉（Venetoclax）联合阿扎胞苷和西达本胺治疗难治复发急性髓系白血病6例报告并文献复习

    

  1. 北京大学人民医院，北京大学血液病研究所，国家血液系疾病临床医学研究中心；北大-清华生命科学中心
  • 出版日期:2022-10-25 发布日期:2022-11-09
  • 通讯作者: 唐菲菲 E-mail：bjmugirl@163.com
  • 基金资助:
    国家自然科学基金项目（81900178）

Combination of Venetoclax, Azacitidine and Chidamide in treating refractory and relapsed acute myeloid leukemia: six cases reports and literature review

  • Online:2022-10-25 Published:2022-11-09

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摘要： 目的 探讨维奈克拉（Venetoclax）联合阿扎胞苷和西达本胺方案治疗难治复发急性髓系白血病（refractory/relapsed acute myeloid leukemia，R/R AML）患者的临床疗效和安全性。方法 回顾性分析2021年3月15日至2021年11月30日于北京大学人民医院血液科采用Venetoclax联合阿扎胞苷和西达本胺方案治疗的6例R/R AML患者的疗效及安全性，同时监测并统计患者在诱导期间不同时间点（第7天、第14天、第21天和第28天）的Venetoclax稳态谷浓度（Cmin）。 结果 6例R/R AML患者中，3例观察到临床反应，其中完全缓解（complete remission，CR）2例，CR伴血液学不完全恢复（CR with incomplete hematological recovery，CRi）1 例。中位随访时间为178 d，5例患者存活，总生存率为83.3%（5/6）。6例患者诱导第7天、第14天、第21天和第28天的Venetoclax稳态Cmin分别为（3 181.67±1 631.90） ng/mL，（2 688.67±1 926.36） ng/mL，（2 142.17±1 380.35） ng/mL，（2 766.67±1 138.55） ng/mL。结论 Venetoclax联合阿扎胞苷和西达本胺方案可提高R/R AML患者的疗效，有望成为该类患者挽救性治疗的可行选择之一。

关键词: 急性髓系白血病, 难治复发, 维奈克拉, 阿扎胞苷, 西达本胺

Abstract: Objective To investigate the clinical efficacy and safety of Venetoclax combined with Azacitidine and Chidamide in treating the patients with refractory and relapsed acute myeloid leukemia (R/R AML). Methods The efficacy and safety of Venetoclax combined with Azacitidine and Chidamide for 6 R/R AML patients treated in the Department of Hematology, Peking University People's Hospital, from March 15, 2021 to November 30, 2021, were retrospectively analyzed. The steady-state trough concentrations (Cmin) of Venetoclax at different times during the induction period (day 7, 14, 21 and 28) were monitored and counted. Results Among the 6 R/R AML patients, 3 patients showed clinical response, including 2 complete remission (CR) and 1 CR with incomplete hematological recovery (CRi). The median follow-up time was 178 days. There were 5 patients currently alive, with an overall survival (OS) rate of 83.3%(5/6). The steady-state Cmin of Venetoclax on day 7, 14, 21 and 28 were (3 181.67±1 631.90) ng/mL, (2 688.67±1 926.36) ng/mL, (2 142.17±1 380.35) ng/mL, (2 766.67±1 138.55) ng/mL, respectively. Conclusions Venetoclax combined with Azacitidine and Chidamide can improve the clinical efficacy in R/R AML patients, and such a combination is expected to be one of the feasible options for the salvage therapy of R/R AML patients.

Key words: Acute myeloid leukemia, Refractory/relapsed, Venetoclax, Azacitidine, Chidamide

中图分类号: 

  • R733.7