维奈克拉联合用药治疗急性髓细胞白血病作用机制的研究现状  

Research status in mechanisms of venetoclax combined with other drugs for treatment of acute myeloid leukemia

作　　者：范晨阳 许鑫欣 孙维龙 施伟鹏 陶霞 竺佳 李帝萱 杨向东[1] Fan Chenyang;Xu Xinxin;Sun Weilong;Shi Weipeng;Tao Xia;Zhu Jia;Li Dixuan;Yang Xiangdong(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300380,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,300380

出　　处：《国际输血及血液学杂志》2021年第5期376-382,共7页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金(81774048)。

摘　　要：B细胞白血病/淋巴瘤(BCL)-2选择性抑制剂维奈克拉(venetoclax)治疗年龄>75岁或者不适宜接受高剂量诱导化疗的急性髓细胞白血病(AML)患者有效。维奈克拉的作用机制为诱导BCL-2依赖的肿瘤细胞凋亡。临床研究结果显示,维奈克拉可与去甲基化药物(HMA)、阿糖胞苷或者小分子抑制剂通过抗耐药、代谢组学、基因组学、抑制拮抗作用等机制发挥协同作用,因此联合用药疗效较单药更为显著。维奈克拉联合用药在临床上应用逐渐普及。为维奈克拉治疗AML的临床用药提供理论基础,笔者拟就维奈克拉联合HMA、小分子抑制剂和细胞毒性药物治疗AML的作用机制及临床疗效的研究现状进行阐述。Venetoclax,a selective inhibitor of B-cell leukemia/lymphoma(BCL-2),is effective in patients with acute myeloid leukemia(AML)who are older than 75 years old or not suitable for high-dose induction chemotherapy.Venetoclax induces BCL-2 dependent apoptosis in tumor cells.Clinical studies have shown that venetoclax has synergistic effects with hypomethylation agents(HMA),cytarabine,or small molecule inhibitors through mechanisms of resistance,metabolomics,genomics,and inhibitory antagonism.Therefore,combination effect of venetoclax is more significant than that of single agents.And clinical applications of venetoclax combination are gradually popularized.In order to provide theoretical basis for treatment of AML with venetoclax,this article introduces mechanisms and clinical efficacies of venetoclax combined with HMA,small molecule inhibitors and cytotoxic drugs in treatment of AML.

关 键 词：白血病 髓样 急性 药物疗法 联合 原癌基因蛋白质C-BCL-2 药理作用分子作用机制 维奈克拉 

分 类 号：R733.71[医药卫生—肿瘤]