维奈克拉联合阿扎胞苷治疗多发性骨髓瘤继发急性髓系白血病1例并文献复习  

Venetoclax combined with azacitidine in treatment of acute myeloid leukemia secondaryto multiple myeloma: report of 1 case and review of literature

作　　者：陈阳 魏军安 冯友繁[1] 伏媛[1] 陈巧琳 张启科[1] 魏小芳 CHEN Yang;WEI Junan;FENG Youfan;FU Yuan;CHEN Qiaolin;ZHANG Qike;WEI Xiaofang(Department of Hematology,Gansu Provincial Hospital,Lanzhou,Gansu 730000,China;不详)

机构地区：[1]甘肃省人民医院血液科,甘肃兰州730000 [2]兰州市榆中县三角城卫生院,甘肃兰州730000

出　　处：《中华全科医学》2025年第5期899-902,共4页Chinese Journal of General Practice

基　　金：甘肃省自然科学基金项目(22JR5RA660);甘肃省人民医院院内青年培育项目(23GSSYF-333);甘肃省卫生健康行业科研项目(GSWSKY2023-78)。

摘　　要：本文回顾性分析甘肃省人民医院1例应用维奈克拉联合阿扎胞苷治疗的多发性骨髓瘤持续缓解状态下继发急性髓系白血病患者的临床资料,并复习相关文献。该例患者为67岁男性,诊断为多发性骨髓瘤(IgA-κ型,DSⅢ期,ISSⅡ期,R-ISSⅠ期),先后经VRD诱导治疗、自体干细胞移植术后获完全缓解,后来那度胺维持治疗,在持续完全缓解状态下,患者于诊断后的4年4个月继发急性髓系白血病(高危组),给予维奈克拉联合阿扎胞苷治疗。患者第一疗程后急性髓系白血病形态学完全缓解,微小残留病(minimal residual diease, MRD)阴性,临床症状改善明显。相同治疗共3个疗程后,骨髓细胞形态急性髓系白血病持续缓解,但异常浆细胞比例明显升高,多发性骨髓瘤复发,患者放弃治疗。We retrospectively analyzed the clinical data of a patient of acute myeloid leukemia secondary to multiple myeloma treated with venetolclax combined with azacidacidin in Gansu Provincial People's Hospital and reviewed the relevant literature.This patient,a 67-year-old man,was diagnosed multiple myeloma(IgA-κ,DSⅢ,ISSⅡ,R-ISSⅠ),after VRD induction and autologous stem cell transplantation,achieved complete remission and then lenalidomide maintenance therapy.In a state of continuous complete remission,the patient developed acute myeloid leukemia(high-risk group)4 years and 4 months after diagnosis,then given venetolclax combined with azacidacidin.After the first course of treatment,the patient had complete morphologic remission of acute myeloid leukemia,MRD was negative,and the clinical symptoms improved significantly.After a total of 3 courses of the same treatment,the myeloid morphology of acute myeloid leukemia persisted in remission,but the proportion of abnormal plasma cells increased significantly,multiple myeloma recurred,and the patient abandoned treatment.

关 键 词：多发性骨髓瘤 急性髓系白血病 维奈克拉 阿扎胞苷 

分 类 号：R733.3[医药卫生—肿瘤] R730.53[医药卫生—临床医学]