氟马替尼联合维奈克拉为基础的方案治疗费城染色体阳性白血病6例疗效分析  

Efficacy analysis of flumatinib combined with venetoclax-based regimen in 6 cases with Philadelphia chromosome-positive leukemias

作　　者：黄斯漫 万超玲 张彤彤[1] 薛胜利[1] Huang Si-man;Wan Chao-ling;Zhang Tong-tong;Xue Sheng-li(National Clinical Research Center for Hematologic Diseases,Jiangsu Institute of Hematology,Department of Hematology,The FirstAffiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)

机构地区：[1]国家血液系统疾病临床医学研究中心,江苏省血液研究所,苏州大学附属第一医院血液科,江苏苏州215006

出　　处：《四川生理科学杂志》2024年第10期2132-2134,2182,共4页

基　　金：国家自然科学基金(编号:81970138,编号:82270165);江苏省自然科学基金(编号:BK20221235);江苏省“333工程”人才项目;江苏省科技厅社会发展面上项目(编号:BE2021649);姑苏卫生人才项目(编号:GSWS2019007)。

摘　　要：目的:评估氟马替尼联合维奈克拉为基础的方案治疗费城染色体阳性(Philadelphia chromosome-positive,Ph+)白血病的疗效;方法:纳入苏州大学附属第一医院血液科2021年2月至2022年4月使用氟马替尼联合维奈克拉治疗的6例费城染色体阳性急性白血病患者,回顾性分析联合方案的疗效及安全性;结果:在纳入的6例患者中,3例为初诊费城染色体阳性混合细胞白血病(Mixed phenotype acute leukemia,MPAL)患者,1例为初诊费城染色体阳性急性髓系白血病(Acute myeloid leukemia,AML)患者,1例为复发Ph+AML患者,1例为慢粒急髓变(Chronic myeloid leukemia at myeloid blastic phase,CML-MBP)患者,1例患者使用氟马替尼联合维奈克拉方案,5例患者接受氟马替尼联合维奈克拉及去甲基化药物方案;1周期后总体缓解率为100%,4例患者取得完全缓解,1例患者达到完全缓解伴血液学不完全恢复,1例患者达到形态学无白血病状态;1例患者分子学反应实现完全分子反应(Complete molecular response,CMR),3例为主要分子学反应(Major molecular response,MMR),2例未达到MMR;4例患者遗传学反应为完全细胞遗传学反应(Complete cytogenic response,CCyR);5例患者续接异基因造血干细胞移植(Allogeneic hematopoietic stem cell transplantation,allo-HSCT)。随访截止至2024年1月,5例患者仍处于缓解状态,1例患者失访。结论:氟马替尼联合维奈克拉为基础的方案治疗费城染色体阳性白血病的疗效确切,耐受性良好。Objectives:To evaluate the efficacy of flumatinib combined with venetoclax-based regimen in the treatment of patients with Philadelphia chromosome-positive(Ph+)leukemias.Methods:A total of 6 patients with Ph+leukemias were enrolled from February 2021 to April 2022 at the First Affiliated Hospital of Soochow University.The efficacy and safety of flumatinib combined with venetoclax-based regimen were analyzed retrospectively.Results:A total of 6 patients with Ph+leukemias were enrolled in this study.1 patients was initially diagnosed with Ph+acute myeloid leukemia(AML)and 3 were initially diagnosed with Ph+mixed phenotype acute leukemia(MPAL),1 patients had chronic myeloid leukemia at myeloid blastic phase(CML-MBP),and 1 Ph+AML patients had relapsed to prior therapy.Moreover,1 patients were treated with flumatinib and venetoclax,5 of 6 patients were treated with flumatinib,venetoclax and HMA regimens.The ORR after 1 cycle was 100%(4 CR,1 CRi,1 MLFS),and a complete molecular response(CMR)was achieved in 1 case,major molecular response(MMR)was achieved in 3(50%)patients,2 case didn’t achieve MMR.In addition,four patients achieved a complete cytogenic response(CCyR)among 4 evaluable patients.Five patients were successfully bridged to allogeneic hematopoietic stem cell transplantation(allo-HSCT).Five patients were in continuous complete remission within the duration of follow-up to January 2024 and 1 patient was lost to follow-up.Conclusion:The combination of flumatinib and venetoclax-based regimen for the treatment of Ph+leukemias is effective and well tolerated.

关 键 词：氟马替尼 维奈克拉 费城染色体阳性白血病 

分 类 号：R733.7[医药卫生—肿瘤]