维奈克拉联合阿扎胞苷治疗初诊慢性粒单核细胞白血病2型4例并文献复习  

Venetoclax combined with azacitidine in the treatment of newly diagnosed chronic myelomonocytic leukemia-2:report of 4 cases and review of literature

作　　者：叶少杰 徐建梅 郭慧梅[1] 赵松颖[1] 王静[1] 薛华[1] Ye Shaojie;Xu Jianmei;Guo Huimei;Zhao Songying;Wang Jing;Xue Hua(Department of Hematology,the Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]河北大学附属医院血液科,保定071000

出　　处：《白血病．淋巴瘤》2023年第11期667-670,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探索维奈克拉联合阿扎胞苷(VA)治疗初诊慢性粒单核细胞白血病(CMML)患者的疗效。方法回顾性分析河北大学附属医院自2022年2月至2023年3月收治的VA方案治疗的4例初诊CMML-2型(CMML-2)患者的临床资料,并复习相关文献。结果4例CMML-2型患者在治疗1个疗程后均达到≥部分骨髓缓解(PMR),随着疗程的延长,总反应率(ORR)和完全缓解率分别为100%和50%。在剂量调整方面,通过动态的衰弱评估及不良反应决定维奈克拉剂量及用药天数。2例获CR的患者1例初始应用维奈克拉200 mg 14 d,1例在维奈克拉400 mg 28 d后因血液学不良反应减量为维奈克拉200 mg 14 d,目前均维持完全缓解。最常见的3、4级不良反应是中性粒细胞减少、血小板减少。结论VA方案一线应用治疗CMML-2型患者较传统单药HMA可能取得更快的缓解,安全性较好。Objective To explore the efficacy of venetoclax plus azacitidine(VA)in the treatment of patients with newly diagnosed chronic myelomonocytic leukemia(CMML).Methods The clinical data of 4 newly diagnosed CMML-2 patients treated with VA regimen in the Affiliated Hospital of Hebei University from February 2022 to March 2023 were retrospectively analyzed,and the related literature was reviewed.Results All 4 CMML-2 patients achieved the effect of≥partial bone marrow remission(PMR)after 1 course of treatment,and with the deepened extension of treatment course,the overall response rate and complete remission(CR)rate was 100%and 50%,respectively.In terms of dose adjustment,the dose and usage day of venetoclax were determined by using dynamic frailty assessment and adverse events.Among the 2 patients who achieved CR,1 patient initially received venetoclax 200 mg for 14 days,and 1 patient received venetoclax 400 mg for 28 days and then the usage reduced to venetoclax 200 mg for 14 days due to hematological adverse events.All 4 patients maintained CR status.The most common grade 3 and 4 adverse events were neutropenia and thrombocytopenia.Conclusions The first-line application of VA regimen in the treatment of newly diagnosed CMML-2 patients may achieve faster remission and better safety compared with traditional HMA monotherapy.

关 键 词：慢性粒单核细胞白血病 维奈克拉 阿扎胞苷 治疗结果 

分 类 号：R733.72[医药卫生—肿瘤]