贝林妥欧单抗治疗儿童微小残留病阳性的急性B淋巴细胞白血病临床分析  

Clinical analysis of Blinatumomab in the treatment of acute lymphoblastic leukemia with positive minimal residual disease in children

作　　者：邓绍阳 旷文勇 张本山 何姗 宋娜 郑敏翠 DENG Shaoyang;KUANG Wenyong;ZHANG Benshan;HE Shan;SONG Na;ZHENG Mincui(Department of Hematology and Oncology,Hunan Children′s Hospital&Affiliated Children′s Hospital of Xiangya Medical College,Central South University,Changsha 410000,China)

机构地区：[1]湖南省儿童医院(中南大学湘雅医学院附属儿童院)血液肿瘤科,长沙410000

出　　处：《中国小儿血液与肿瘤杂志》2025年第1期25-29,共5页Journal of China Pediatric Blood and Cancer

摘　　要：目的观察贝林妥欧单抗治疗儿童微小残留病阳性(MRD+)的急性B淋巴细胞白血病(B-ALL)的疗效和不良反应。方法回顾性研究2022年7月—2023年11月湖南省儿童医院血液肿瘤科使用贝林妥欧单抗治疗16例MRD+B-ALL患儿临床资料。结果治疗前8例患者诱导缓解后MRD持续阳性,1例骨髓复发治疗后MRD+,7例MRD转阳。8例完成1个疗程贝林妥欧单抗治疗,8例仅使用15-21天。贝林妥欧单抗治疗后MRD转阴率87.5%。11例患儿桥接异基因造血干细胞移植治疗,中位随访时间5.7(3.6-18.7)个月,16例患儿均存活且MRD均为阴性。不良反应有发热12例,中性粒细胞减少10例,皮疹5例,贫血3例,肝损害3例,胃肠道反应3例,血小板下降2例,细胞因子释放综合征2例,予相应对症处理后均消退,均未影响治疗。结论贝林妥欧单抗治疗儿童MRD+B-ALL缓解率高,不良反应较轻,桥接异基因造血干细胞移植可进一步提高MRD+B-ALL缓解率。Objective To observe the efficacy and adverse reactions of Blinatumomab in the treatment of acute B-ALL with minimal residual disease(MRD)positivity in children.Methods A retrospective study was conducted on the clinical data of 16 children with MRD positive B-ALL who were treated with Blinatumomab in the Hematology and Oncology Department of Hunan Children′s Hospital from July 2022 to November 2023.Results Among the 16 cases of B-ALL.Before treatment,8 patients showed sustained positive MRD after induction remission,with 1 case experiencing bone marrow recurrence and 7 cases of MRD conversion from negative to positive.Eight patients completed one course of treatment with Blinatumomab,while eight patients only used it for 15-21 days.The MRD conversion rate after treatment was 87.5%.Eleven patients were treated with bridging allogeneic hematopoietic stem cell transplantation,and a median follow-up time of 5.7(3.6-18.7)months.All 16 patients survived and had negative MRD.Adverse reactions included fever in 12 cases,neutropenia in 10 cases,rash in 5 cases,anemia in 3 cases,liver damage in 3 cases,gastrointestinal reactions in 3 cases,thrombocytopenia in 2 cases,and cytokine release syndrome in 2 cases.All of the cases with adverse reactions disappeared.Conclusions The response rate of MRD positive B-ALL in children treated with Blinatumomab is high,and the adverse reactions are mild.Bridging allogeneic hematopoietic stem cell transplantation can further improve the response rate of MRD positive B-ALL.

关 键 词：贝林妥欧单抗 儿童 微小残留病 急性淋巴细胞白血病 

分 类 号：R733.71[医药卫生—肿瘤]