维奈克拉联合阿扎胞苷在初治成人急性髓系白血病中的临床研究  

Clinical Study of Venetoclax Combined with Azacitidine in the Treatment of Patients with Adult Acute Myeloid Leukemia

作　　者：郑永亮 丁婷 肖晓芳[2] 董思 曾俊权 陈懿建 ZHENG Yong-Liang;DING Ting;XIAO Xiao-Fang;DONG Si;ZENG Jun-Quan;CHEN Yi-Jian(Department of Hematology,The Affiliated Hospital of Jinggangshan University,Ji'an 343000,Jiangxi Province,China;Department of Hematology,Ji'an Central People's Hospital,Ji'an 343000,Jiangui Province,China;Department of Hematology,The First Affiliated Hospital of Garman Medical University,Ganzhou 341000,Jiangexi Province,China)

机构地区：[1]井冈山大学附属医院血液内科,江西吉安343000 [2]吉安市中心人民医院血液内科,江西吉安343000 [3]赣南医科大学第一附属医院血液内科,江西赣州341000

出　　处：《中国实验血液学杂志》2024年第4期1046-1050,共5页Journal of Experimental Hematology

基　　金：江西省卫生健康委科技计划(20203789,202310853);江西省教育厅科技项目(GJJ2209312);江西省地方病(地中海贫血)临床医学研究中心(20223BCG74003);吉安市科技局科技计划专项(20222-201786)。

摘　　要：目的:评价维奈克拉联合阿扎胞苷化疗方案治疗初治成人急性髓系白血病患者的疗效及不良反应。方法:回顾性分析井冈山大学附属医院血液内科2020年1月至2022年12月收治的48例初治成人急性髓系白血病患者,其中26例接受维奈克拉联合阿扎胞苷化疗(观察组),22例接受柔红霉素+阿糖胞苷化疗(对照组),对比两组之间完全缓解率、客观缓解率、无进展生存期、总生存期及不良反应的差异。结果:两组患者在治疗前的年龄、性别比、三系血细胞绝对值及骨髓原始细胞比例均无明显统计学差异(P>0.05)。观察组的完全缓解率及客观缓解率均明显高于对照组(P<0.05);两组患者治疗后骨髓抑制、粒细胞缺乏、继发感染、黏膜损害、肝肾损害、心脏毒性、胃肠道毒性等不良反应反生率均无显著差异(P>0.05)。观察组的中位PFS及中位OS均显著优于对照组(P<0.05)。结论:维奈克拉联合阿扎胞苷在初治成人急性髓系白血病中的缓解率高于常规化疗,维奈克拉联合阿扎胞苷化疗能够减少血液系统及非血液系统相关副反应的基础上延长患者缓解期及生存期。Objective:To evaluate the efficacy and side effects of venetoclax combined with azacitidine chemotherapy in the treatment of previously untreated adult patients with acute myeloid leukemia(AML).Methods:A retrospective analysis was performed on 48 untreated adult AML patients admitted to the Department of Hematology,Affiliated Hospital of Jinggangshan University from January 2020 to December 2022.Among them,26 patients received venetoclax combined with azacitidine chemotherapy(observation group),and 22 patients received daunorubicin plus cytarabine chemotherapy(control group).The differences in complete response(CR)rate,objective response rate(ORR),progression-free survival(PFS),overall survival(OS)and adverse reactions(AR)were compared between the two groups.Results:There was no significant difference in age,sex ratio,absolute value of tri-lineage cell and proportion of bone marrow primordial cells between the two groups before treatment(all P>0.05).The CR rate and the ORR rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,there were no significant difference in the adverse reactions such as myelosuppression,granulocytosis,secondary infection,mucosal damage,liver and kidney damage,cardiotoxicity and gastrointestinal toxicity between the two groups(P>0.05).The median PFS and the median OS of the observation group were significantly better than those of the control group(P<0.05).Conclusion:The remission rate of venetoclax combined with azacitidine was higher than that of conventional chemotherapy in previously untreated adult acute myeloid leukemia.Venetoclax combined with azacitidine chemotherapy could reduce hematologic related side reactions and prolong the remission period and survival of AML patients.

关 键 词：维奈克拉 阿扎胞苷 急性髓系白血病 

分 类 号：R733.7[医药卫生—肿瘤]