贝林妥欧单抗联合化疗治疗难治复发ALL患者的疗效及其对血清IL-6、IL-17水平的影响  

Efficacy of Belintuozumab combined with chemotherapy in the treatment of refractory and relapsed ALL patients and its influence on serum IL-6 and IL-17 levels

作　　者：刘欣[1] 訾建杰[1] 舒郁 郑倩 闫慧[1] LIU Xin;ZI Jianjie;SHU Yu;ZHENG Qian;YAN Hui(Department of Hematology,Tangshan People′s Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]河北省唐山市人民医院血液科,河北唐山063000

出　　处：《检验医学与临床》2024年第22期3321-3325,共5页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究课题计划项目(20240678)。

摘　　要：目的探讨贝林妥欧单抗联合化疗治疗难治复发急性淋巴细胞白血病(ALL)患者的疗效及其对血清白细胞介素(IL)-6、IL-17水平的影响。方法回顾性选取2017年1月至2024年1月在该院接受治疗的78例难治复发ALL患者作为研究对象,根据治疗方案不同将难治复发ALL患者分为研究组和对照组,每组39例。研究组采用HyperCVAD方案+贝林妥欧单抗治疗,费城染色体阳性(PH+)患者加用达沙替尼治疗,对照组采用HyperCVAD方案治疗,PH+患者加用达沙替尼治疗,两组均治疗1个疗程。治疗1个疗程后评估患者临床疗效;比较两组治疗前、治疗1个疗程后血常规指标[白细胞计数(WBC)、血小板计数(PLT)和血红蛋白(Hb)]及血清IL-6、IL-17水平;采用Kendall′s tau相关分析血清IL-6、IL-7水平与难治复发ALL患者疗效的相关性;比较两组不良反应发生情况。结果研究组总有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后WBC及血清IL-6、IL-17水平均低于对照组,PLT、Hb水平均高于对照组,差异均有统计学意义(P<0.05)。完全缓解患者血清IL-6、IL-17水平最低,其次为完全缓解伴血液学不完全恢复和难治性疾病患者,疾病进展患者最高,差异均有统计学意义(P<0.05)。Kendall′s tau相关分析结果显示,血清IL-6、IL-17水平与难治复发ALL患者疗效均呈负相关(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论贝林妥欧单抗联合达沙替尼能够有效改善难治复发ALL患者血常规指标水平,减轻机体炎症反应,提升患者临床疗效,并且血清IL-6、IL-17水平与患者疗效密切相关。Objective To investigate the efficacy of berintuzumab combined with chemotherapy in the treatment of refractory and relapsed acute lymphoblastic leukemia(ALL)and its effect on serum interleukin(IL)-6 and IL-17 levels.Methods A total of 78 patients with refractory and relapsed ALL treated in this hospital from January 2017 to January 2024 were retrospectively selected as the research objects.According to different treatment regimens,patients with refractory and relapsed ALL were divided into study group and control group,with 39 cases in each group.The study group was treated with HyperCVAD regimen+berintuomab,and Philadelphia staining positive(PH+)patients were treated with dasatinib.The control group was treated with HyperCVAD regimen,and PH+patients were treated with dasatinib.Both groups were treated for 1 course.After the first course of treatment,the clinical efficacy was evaluated.The blood routine indexes[white blood cell count(WBC),platelet count(PLT)and hemoglobin(Hb)],and serum IL-6 and IL-17 levels were compared between the two groups before treatment and after one course of treatment.Kendall′s tau correlation was used to analyze the correlation between serum IL-6,IL-7 levels and the efficacy of refractory and relapsed ALL patients.The incidence of adverse reactions was compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the WBC,serum IL-6 and IL-17 levels in the study group were lower than those in the control group,the PLT and Hb levels were higher than those in the control group,and the differences were statistically significant(P<0.05).The serum levels of IL-6 and IL-17 were the lowest in patients with complete remission,followed by patients with complete remission with incomplete hematologic recovery and refractory disease,and the highest in patients with progressive disease,and the differences were statistically significant(P<0.05).Kendall′s tau co

关 键 词：难治复发急性淋巴细胞白血病 贝林妥欧单抗 白细胞介素-6 白细胞介素-17 疗效 

分 类 号：R733.4[医药卫生—肿瘤] R446.1[医药卫生—临床医学]