维奈托克联合TKI及含地塞米松小剂量化疗对复发/难治Ph+急性B淋巴细胞白血病的疗效分析  

Efficacy analysis of Venetoclax combined with TKI and dexamethasone-containing low-dose chemotherapy for relapsed/refractory Ph+acute B-lymphoblastic leukemia

作　　者：田云 艾昊 纪旭 魏旭东 宋永平 尹青松 Tian Yun;Ai Hao;Ji Xu;Wei Xudong;Song Yongping;Yin Qingsong(Department of Hematology,the Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院血液科,郑州450008

出　　处：《中华医学杂志》2022年第10期745-748,共4页National Medical Journal of China

基　　金：郑州大学青年教师(自然科学)基础研究培育基金(JC202050015)。

摘　　要：分析郑州大学附属肿瘤医院采用Bcl-2抑制剂维奈托克联合酪氨酸激酶抑制剂(TKI)及含地塞米松小剂量化疗方案治疗5例复发/难治(R/R)费城染色体阳性急性B淋巴细胞白血病(Ph+B-ALL)的临床资料,并评估疗效及安全性。5例患者中2例伴T315I突变采用帕纳替尼,3例采用氟马替尼。结果显示,4例微小残留病(MRD)阳性患者,3例短期内达完全分子学缓解(CMR),1例无效;1例形态学复发患者1个月达完全缓解(CR),总有效率为80%。不良反应包括皮肤色素沉着、胃肠道反应、乏力和Ⅰ~Ⅱ度骨髓抑制。The clinical data of five cases of relapsed/refractory(R/R)Philadelphia chromosome-positive acute B-lymphocytic leukaemia(Ph+B-ALL)treated with Bcl-2 inhibitor venetoclax combined with tyrosine kinase inhibitor(TKI)and dexamethasone-containing low-dose chemotherapy regimen at Zhengzhou University Cancer Hospital were analyzed,and the efficacy and safety were evaluated.Ponatinib was used in two of the five patients with T315I mutation,and flumatinib was used in other three patients.The results showed that,of the four minimal residual disease(MRD)positive patients,three achieved complete molecular remission(CMR)in the short term and one was ineffective.Another patient with morphological recurrence reached CR in one month.The overall response rate was 80%.Treatment related adverse reactions included mild skin pigmentation,gastrointestinal reactions,fatigue,and gradeⅠ-Ⅱbone marrow suppression.

关 键 词：白血病 幼淋巴细胞 B细胞 酪氨酸激酶抑制剂 微小残留病 复发难治 

分 类 号：R733.71[医药卫生—肿瘤]