维奈克拉致Ph样急性淋巴细胞白血病肿瘤溶解综合征1例  

Venetoclax induced Ph-like acute lymphoblastic leukemia tumor lysis syndrome:A case report

作　　者：丁月玲[1] 成志勇[2] 付建珠 李宗英 丁玉芝 柳倩[2] DING Yueling;CHENG Zhiyong;FU Jianzhu;LI Zongying;DING Yuzhi;LIU Qian(Department of Hematology,Ding Zhou People’s Hospital,Dingzhou Hebei 073000;Department of Hematology,Baoding No.1 Hospital,Baoding Hebei 071000,China)

机构地区：[1]定州市人民医院血液内科,河北定州073000 [2]保定市第一医院血液内科,河北保定071000

出　　处：《临床与病理杂志》2024年第5期771-775,共5页Journal of Clinical and Pathological Research

基　　金：河北省重点研发计划项目(223777105D);保定市科技计划项目(2341ZF232)。

摘　　要：维奈克拉是一种选择性B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)抑制剂,目前广泛应用于造血系统恶性肿瘤治疗,疗效良好。其主要不良反应包括血细胞减少、感染、消化道反应、电解质紊乱等,在慢性淋巴细胞白血病中可能出现严重肿瘤溶解综合征。2023年1月6日保定市第一医院收治1例75岁男性难治复发Ph样急性淋巴细胞白血病患者,在应用维奈克拉100 mg后3.5 h出现典型的肿瘤溶解综合征,伴有急性肾功能衰竭、高钾、低钙、少尿、高尿酸,并迅速出现严重的血细胞减少、粒细胞缺乏。经对症支持治疗后,肾功能恢复正常,但仍持续全血细胞减少伴严重感染,最终死亡。Venetoclax is a selective B-cell lymphoma-2(Bcl-2)inhibitor,widely used in the treatment of hematologic malignancies with good efficacy.Its primary adverse effects include cytopenias,infections,gastrointestinal reactions,and electrolyte disturbances,with the potential for severe tumor lysis syndrome in chronic lymphocytic leukemia.The patient,a 75-year-old male,was admitted to Baoding No.1 Hospital on January 6,2023,with a diagnosis of refractory relapsed Ph-like acute lymphoblastic leukemia.Tumor lysis syndrome with acute renal failure,hyperkalemia,hypocalcemia,oliguria,hyperuricemia,and rapid onset of severe cytopenia and neutropenia occurred 3.5 hours after administering 100 mg of venetoclax.Despite symptomatic and supportive treatment leading to the recovery of renal function,the patient continued to experience persistent pancytopenia with severe infections and ultimately died.

关 键 词：急性淋巴细胞白血病 肿瘤溶解综合征 维奈克拉 

分 类 号：R733.71[医药卫生—肿瘤]