Venetoclax联合LDAC方案治疗复发难治性急性髓细胞白血病的疗效及对血清VEGF、survivin表达水平的影响  

Efficacy of Venetoclax Combined with LDAC Regimen in the Treatment of Relapsed and Refractory Acute Myeloid Leukemia and Its Effect on Serum VEGF and Survivin Expression Levels

作　　者：王萍 高红秀 任晓艳 郭力 吴胜胜 陆娟[2] WANG Ping;GAO Hongxiu;REN Xiaoyan(Zhumadian Central Hospital,Zhumadian,463000)

机构地区：[1]河南省驻马店市中心医院,463000 [2]河南省南阳市第一人民医院,473000

出　　处：《实用癌症杂志》2022年第2期341-344,共4页The Practical Journal of Cancer

基　　金：河南省科技攻关项目(编号:17210230124)。

摘　　要：目的探究Venetoclax(VEN)联合低剂量阿糖胞苷(LDAC)方案治疗复发难治性急性髓细胞白血病(AML)的疗效及对血清血管内皮生长因子(VEGF)、凋亡存活蛋白(survivin)表达水平影响。方法选择82例复发难治性AML患者,按照化疗方法不同分为观察组(n=41,VEN+LDAC治疗)和对照组(n=41,安慰剂+LDAC治疗),评价2组近期疗效、不良反应、生存时间及治疗前后血清VEGF、survivin表达水平。结果治疗1个标准化疗方案后,观察组总缓解率高于对照组(95.12%vs 80.49%,P<0.05)。治疗后2组血清VEGF、survivin表达水平均下降,且观察组低于对照组(P<0.05)。2组患者发生低钾血症、恶心呕吐、肺部感染、白细胞减少、血小板减少等不良反应概率无显著差异(P>0.05)。治疗后随访1年,2组死亡率无显著差异(P>0.05),但观察组中位生存时间较对照组更长(P<0.05)。结论VEN联合LDAC方案治疗复发难治性AML能有效提高临床缓解率和延长生存时间,降低血清VEGF、survivin水平,且不良反应率低,是一种安全有效的治疗方法。Objective To explore the efficacy of Venetoclax(VEN)combined with low-dose cytarabine(LDAC)regimen in the treatment of relapsed and refractory acute myeloid leukemia(AML)and their impact on serum vascular endothelial growth factor(VEGF)and apoptotic survivin expression levels.Methods 82 patients with relapsed and refractory AML were selected and divided into the observation group(n=41,VEN+LDAC treatment)and the control group(n=41,Placebo+LDAC treatment).Short-term efficacy,adverse reactions,survival time,and serum VEGF and survivin expression levels before and after treatment were assessed in the 2 groups.Results After treatment with a standard chemotherapy regimen,the total remission rate of the observation group was higher than that of the control group(95.12%vs80.49%,P<0.05).The serum VEGF and survivin expression levels of the 2 groups decreased after treatment,and the observation group was lower than the control group(P<0.05).There was no significant difference in the probability of adverse reactions such as hypokalemia,nausea and vomiting,lung infection,leukopenia,and thrombocytopenia between the 2 groups(P>0.05).The 2 groups were followed up for 1 year after treatment,and there was no significant difference in the mortality rate(P>0.05),but the median survival time of the observation group was longer than that of the control group(P<0.05).Conclusion VEN combined with LDAC regimen in the treatment of relapsed and refractory AML can effectively improve the clinical remission rate and prolong survival time,reduce the serum VEGF and survivin levels,and has a low adverse reaction rate.It is a safe and effective treatment method.

关 键 词：Venetoclax 阿糖胞苷 复发难治性急性髓细胞白血病 血管内皮生长因子 

分 类 号：R733.71[医药卫生—肿瘤]