维奈克拉联合阿扎胞苷治疗成人不适合强化疗急性髓系白血病的疗效及安全性分析  

The Efficacy and Safety of Venetoclax Combined with Azacitidine in the Treatment of Adult Patients with Acute Myeloid Leukemia Who Are Unfit for Intensive Chemotherapy

作　　者：王开月 范柄汝 张倩雯 韩孟汝 葛晓燕[1] WANG Kai-Yue;FAN Bing-Ru;ZHANG Qian-Wen;HAN Meng-Ru;GE Xiao-Yan(Department of Hemotology,The Second Hospital of Shanxi Medicine University,Taiyuan 030000,Shanxi Province,China)

机构地区：[1]山西医科大学第二医院血液科,山西太原030000

出　　处：《中国实验血液学杂志》2024年第2期342-346,共5页Journal of Experimental Hematology

摘　　要：目的:观察维奈克拉(VEN)联合阿扎胞苷(AZA)治疗成人不适合强化疗急性髓系白血病(unfit AML)的临床疗效及安全性。方法:收集2021年1月至2022年5月山西医科大学第二医院收治的21例接受VEN联合AZA治疗的成人unfit AML患者的临床资料,回顾性分析该联合方案的疗效及安全性。结果:21例unfit AML患者接受VEN联合AZA治疗1个疗程后,16例达完全缓解(CR)/完全缓解伴血液学不完全恢复(CRi),2例达部分缓解(PR),总反应率(ORR)为85.7%。16例达CR/CRi的患者中13例微小残留病(MRD)转阴。11例预后不良患者中,8例达CR/CRi。至随访截止日期,21例患者的中位总生存(OS)期未达到,1年的OS率为61.7%。VEN联合AZA的主要不良反应为骨髓抑制、胃肠道反应和感染。发生3-4级白细胞减少13例、中性粒细胞减少7例、贫血7例、血小板减少4例。发生胃肠道反应和感染的患者分别为11例和7例。以上不良反应均可控且可耐受。无肿瘤溶解综合征发生,未发生感染相关死亡。结论:VEN联合AZA方案可使成人unfit AML患者快速获得深度缓解,安全性良好。Objective:To observe the clinical efficacy and safety of venetoclax(VEN)combined with azacitidine(AZA)in the treatment of adult acute myeloid leukemia(AML)patients who are unfit for intensive chemotherapy.Methods:The clinical data of 21 adult patients with unfit AML who were treated with VEN combined with AZA in the Second Hospital of Shanxi Medical University from January 2021 to May 2022 were collected,and the efficacy and safety were analyzed retrospectively.Results:After one course of treatment with VEN and AZA,16 out of 21 unfit AML patients reached complete remission(CR)/CR with incomplete hematologic recovery(CRi),2 patients reached partial remission(PR),the overall response rate(ORR)was 85.7%.Among the 16 patients with CR/CRi,13 achieved minimal residual disease(MRD)negativity.Among the 11 patients with adverse prognosis,8 achieved CR/CRi.By the deadline of follow-up,the median overall suivival(OS)of the entire cohort was not reached,with 1-year OS rate of 61.7%.The main adverse events of VEN combined with AZA were myelosuppression,gastrointestinal reactions and infections.There were 13 cases of leukopenia,7 cases of neutropenia,7 cases of anemia,4 cases of thrombocytopenia,and these hematologic adverse events were all grade 3-4.There were 11 cases with gastrointestinal reactions and 7 cases with infections.The above adverse events were controllable and tolerable.No tumor lysis syndrome or infection related death occurred.Conclusion:VEN combined with AZA can quickly achieve deep remission in adult patients with unfit AML,and it shows a good safety profile.

关 键 词：维奈克拉 阿扎胞苷 不适合强化疗 急性髓系白血病 疗效 

分 类 号：R733.71[医药卫生—肿瘤]