贝林妥欧单抗为基础的联合方案治疗CD19阳性系列模糊急性白血病的疗效分析  

Blinatumomab-based combination treatment for CD19-positive acute leukemia of an ambiguous lineage

作　　者：吴小霞[1] 杨贞[1] 陆棽琪 张馨慧 孙爱宁[1] 周惠芬[1] 吴德沛[1] 苗瞄[1] Wu Xiaoxia;Yang Zhen;Lu Shenqi;Zhang Xinhui;Sun Aining;Zhou Huifen;Wu Depei;Miao Miao(The First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,National Clinical Research Center for Hematologic Diseases,Key Laboratory of Thrombosis and Hemostasis Under Ministry of Health,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院、江苏省血液病研究所、国家血液系统疾病临床医学研究中心、国家卫生健康委员会血栓与止血重点实验室,苏州215006

出　　处：《中华血液学杂志》2024年第11期1051-1054,共4页Chinese Journal of Hematology

基　　金：国家重点研发计划(2022YFC2502700);国家自然科学基金(82020108003);江苏省血液病医学创新中心(CXZX202201)。

摘　　要：系列模糊急性白血病(ALAL)是一种罕见的急性白血病类型,治疗难度极大。本文报道6例成功接受贝林妥欧单抗为基础的联合方案作为一线治疗的CD19阳性ALAL患者。其中5例为B/髓表型,1例为B/T表型。经过1个周期的贝林妥欧单抗联合治疗后,6例患者均获完全缓解(CR)。此外3例患者达到了流式细胞术微小残留病(MRD)阴性(<0.01%);4例患者可评估分子学MRD,其中2例患者获得了分子学缓解。整个治疗中的最佳治疗反应:5例患者(83.3%)达到流式细胞术MRD阴性,4例有可评估分子学MRD的患者全部达到分子学缓解。中位随访时间为15个月,总生存率为100%,无事件生存率为83.3%。本研究初步证明贝林妥欧单抗为基础的联合方案是一线治疗CD19阳性ALAL患者的有效、安全疗法。Acute leukemia of ambiguous lineage(ALAL)is a rare type of acute leukemia and is extremely difficult to treat.Here,we present six patients with CD19-positive ALAL who were successfully treated with blinatumomab-based combination treatment in the front-line setting.Five were diagnosed with B-cell/myeloid mixed phenotype acute leukemia(MPAL)and one with B-cell/T cell MPAL.All six patients achieved complete remission after one cycle of blinatumomab combination treatment.Furthermore,3(50%)patients achieved MRD-negative(<0.01%)by flow cytometry and 2(50%)of four patients with evaluable molecular MRD achieved molecular remission.At some point during the treatment,5(83.3%)patients achieved MRD negativity and all four patients with evaluable molecular MRD had molecular remission.The overall survival was 100%,and the event-free survival was 83.3%after a median follow-up time of 15 months.This study provides preliminary evidence that blinatumomab-based combination therapy is an effective and safe treatment for patients with CD19-positive ALAL in the front-line setting.

关 键 词：联合方案 贝林 急性白血病 总生存率 流式细胞术 CD19 一线治疗 无事件生存率 

分 类 号：R733.7[医药卫生—肿瘤]