吉瑞替尼一线联合化疗治疗FLT3突变阳性初诊急性髓系白血病16例的疗效及安全性分析  

Efficacy and safety of gilteritinib combined with chemotherapy in newly diagnosed FLT3-mutated acute myeloid leukemia

作　　者：雷雨田 赵晓丽 洪鸣[1] 刘文洁 孙倩[1] 钱思轩[1] 王帅[1] 朱雨[1] Lei Yutian;Zhao Xiaoli;Hong Ming;Liu Wenjie;Sun Qian;Qian Sixuan;Wang Shuai;Zhu Yu(Department of Hematology,Jiangsu Province Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院血液科,南京210029

出　　处：《中华血液学杂志》2024年第12期1129-1133,共5页Chinese Journal of Hematology

基　　金：白求恩·医学科学研究基金(2022-YJ-085-J-Z-ZZ-037)。

摘　　要：为评估吉瑞替尼联合化疗治疗初诊FLT3突变阳性急性髓系白血病(AML)的疗效与安全性,我们回顾性收集于江苏省人民医院就诊的16例初诊FLT3突变阳性AML患者的临床资料。患者接受经典"3+7"方案或VA(维奈克拉+阿扎胞苷)方案诱导治疗,并均在检出FLT3-ITD/TKD突变后加用吉瑞替尼。16例患者中,男12例,女4例,中位年龄为52.5(15~76)岁;FLT3-ITD突变15例,FLT3-TKD突变1例。经过1个周期治疗后,完全缓解(CR)/CR伴不完全血细胞恢复(CRi)率达到93.8%(15/16),其中13例患者达到流式细胞术检测的可检测残留病(MRD)阴性。巩固治疗期间所有患者均达到CR_(MRD-),14例进行二代测序检测并均达FLT3突变阴性。截至2024年5月,中位随访时间为18个月,12个月总生存率和无复发生存率均为73.9%。诱导期间9例(56.2%)患者出现感染性发热,巩固与维持治疗期间3例患者发生3级QTc延长,治疗相关不良反应总体可耐受。This study aimed to assess the efficacy and safety of gilteritinib combined with chemotherapy in treating newly diagnosed FLT3-mutated acute myeloid leukemia(AML).We retrospectively collected clinical data from 16 patients newly diagnosed with FLT3-mutated AML at Jiangsu Province Hospital.Patients received induction therapy with the classic"3+7"regimen or the VA regimen,and all patients were immediately supplied with gilteritinib after detecting FLT3-ITD/TKD mutations.Of the 16 patients,12 were male and 4 were female,with a median age of 52.5 years(range:15-76 years).Additionally,15 patients had FLT3-ITD mutations and 1 had FLT3-TKD mutation.The complete remission(CR/CRi)rate was 93.8%(15/16)after the first cycle of gilteritinib-based induction therapy,with 13 patients achieving MRD negativity detected with flow cytometry.All patients achieved a CR MRD-during the consolidation phase.FLT3 mutation clearance was achieved among all 14 patients who underwent next-generation sequencing(NGS)analysis.The 12-month overall survival and relapse-free survival rates were both 73.9%,respectively,with a median followup of 18 months.Nine(56.2%)patients experienced infectious fever during the induction therapy.Three patients had grade 3 QTc prolongation during consolidation and maintenance therapy.Treatment-related adverse events were generally tolerable.

关 键 词：江苏省人民医院 急性髓系白血病 感染性发热 诱导治疗 阿扎胞苷 疗效与安全性 无复发生存率 总生存率 

分 类 号：R733.71[医药卫生—肿瘤]