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中国临床研究英文版:2023,36(8):1247-1251
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BCL-2抑制剂维奈克拉——革新急性髓系白血病的治疗格局
(新乡医学院第一附属医院血液科,河南 新乡 453100)
BCL-2 inhibitor venetoclax-innovating the therapeutic pattern of acute myeloid leukemia
(Department of Hematology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan 453100, China)
摘要
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Received:December 27, 2022   Published Online:August 20, 2023
中文摘要: 急性髓系白血病(AML)是一种异质性较强的髓系克隆增殖性肿瘤。化疗和造血干细胞移植是AML主要的治疗手段,虽然可以使患者获得较好的疗效,但老年人由于高龄、生理、认知功能损害及合并症增多等诸多原因不能耐受常规化疗,治疗选择有限,生存期更短,仅有2个月。维奈克拉作为全球首个获批的B细胞淋巴瘤/白血病-2(BCL-2)抑制剂,多项研究表明,阿扎胞苷或地西他滨等去甲基化药物(HMA)及其他低强度化疗方案联合维奈克拉在老年患者中显示出较好的疗效,可显著改善其复合总缓解率和总生存期(CR/CRi 66.4%,中位OS 14.7个月),使更多患者能够过渡到异基因造血干细胞移植(allo-HSCT)阶段。本文就维奈克拉的作用机制、在AML中的临床应用及包括耐药在内的一些相关问题作一简要综述。
Abstract:Acute myeloid leukemia (AML) is a kind of myeloid clonal proliferative tumor with strong heterogeneity. Chemotherapy and hematopoietic stem cell transplantation are the main treatment methods for AML. Although patients can achieve better therapeutic effects, the elderly people cannot tolerate conventional chemotherapy due to many reasons such as advanced age, physiological and cognitive impairment, and increased complications, with limited treatment options and shorter survival period (only 2 months). Venetoclax is the first approved B-cell lymphoma/leukemia-2 inhibitor (BCL-2) in the world. Many studies have shown that hypomethylating agents (HMA) such as azacytidine or dexcitabine and other low-intensity chemotherapy regimens combined with venetoclax has good efficacy in elderly patients, significantly improving combined overall response rate and overall survival (CR/Cri 66.4%, median OS 14.7 months), enable more patients to transition to the allogeneic hematopoietic stem cell transplantation stage (allo-HSCT). This article briefly reviews the mechanism of action of venetoclax, its clinical application in AML and some related issues including drug resistance.
文章编号:     中图分类号:R456    文献标志码:A
基金项目:河南省科技厅科技攻关基金资助项目(182102310276)
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