改良DAV方案治疗初发老年急性髓系白血病:单中心回顾性研究  

Modified DAV in fit elderly patients with untreated de novo acute myeloid leukaemia:a single-centre retrospective analysis

作　　者：潘佳佳 周一乐 毛莉萍[1,2,3] 娄引军 任艳玲[1,2,3] 叶杏浓 杨敏[1,2,3] 钱劼靖 金洁[1,2,3,4] 王华锋 PAN Jiajia;ZHOU Yile;MAO Liping;LOU Yinjun;REN Yanling;YE Xingnong;YANG Min;QIAN Jiejing;JIN Jie;WANG Huafeng(Department of Hematology,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,310000,China;Zhejiang Provincial Key Lab of Hematopoietic Malignancy;Zhejiang Provincial Clinical Research Center for Hematological disorders;Zhejiang U niversity Cancer Center)

机构地区：[1]浙江大学医学院附属第一医院血液科,杭州310000 [2]全省血液肿瘤精准诊疗重点实验室 [3]浙江省血液病临床研究中心 [4]浙江大学癌症研究院

出　　处：《临床血液学杂志》2025年第3期191-197,204,共8页Journal of Clinical Hematology

摘　　要：目的:进一步探索维奈克拉联合“2+5”柔红霉素和阿糖胞苷(改良DAV方案)在适合强化疗的老年急性髓系白血病(AML)患者中的有效性和安全性。方法:对2021年3月—2023年7月接受改良DAV方案诱导化疗的25例老年AML患者进行了回顾性研究。分析总体缓解率(ORR)、复合完全缓解(CRc)率、总体生存期(OS)、无事件生存期(EFS)、缓解持续时间(DOR)以及不良事件等指标。结果:25例患者中,20例经过1个周期改良DAV诱导治疗后达到完全缓解(CR),3例经过1个周期改良DAV诱导治疗达到部分缓解(PR),经过2个周期改良DAV方案治疗后达到CR,2例未缓解。患者中位OS尚未达到,中位EFS为415d。在诱导治疗过程中出现的不良事件包括3~4级中性粒细胞减少症(100.0%)、贫血(100.0%)、血小板减少症(100.0%)以及发热性中性粒细胞减少症(68.0%)。结论:改良DAV方案在老年适合强化疗的初发AML患者中具有良好的疗效和安全性。Objective:To explore the efficacy and safety of venetoclax in combination with‘2+5’daunorubicin and cytarabine chemotherapy(modified DAV regimen)in fit elderly patients with acute myeloid leukemia(AML).Methods:25elderly AML patients receiving modified DAV regimen induction chemotherapy from March 2021to July 2023were retrospectively analyzed.Overall response rate(ORR),composite complete response(CRc)rate,overall survival(OS),event free survival(EFS),duration of remission(DOR),and adverse events were analyzed.Results:Among 25patients,20patients achieved CR after one cycle of induction,3patients achieved PR after one cycle of induction and attained CR after a second modified DAV induction.2patients failed to achieve remission after induction.The median OS was not achieved and the median EFS was 415days.The adverse events during the induction therapy were grade 3-4neutropenia(100%),anemia(100%),thrombocytopenia(100%)and febrile neutropenia(68.0%).Conclusion:Our study demonstrated promising response and safety of modified DAV therapy in elderly fit de novo AML patients.

关 键 词：老年急性髓系白血病 改良DAV方案 有效率 安全性 

分 类 号：R733.7[医药卫生—肿瘤]