克唑替尼治疗间变性淋巴瘤激酶阳性间变大细胞淋巴瘤的研究进展

Research progresses on crizotinib in anaplastic lymphoma kinase-positive anaplastic large cell lymphoma

间变性淋巴瘤激酶阳性(ALK+)间变大细胞淋巴瘤(ALCL)患者对蒽环类药物为基础的常规化疗反应良好,总体反应率可达90%,5年总体生存(OS)率达70%~90%。但是复发/难治性ALK+ALCL患者通常预后不良。克唑替尼作为治疗ALK的靶向抑制剂,对ALK+ALCL患者疗效显著,不良反应轻微,并且可作为造血干细胞移植(HSCT)的桥接治疗或移植后维持治疗。克唑替尼为长期控制和治愈ALK+ALCL创造条件,但是治疗过程中应警惕停药后原发病复发的风险。虽然采用克唑替尼治疗ALK+ALCL疗效显著,但是耐药问题限制其临床应用。克唑替尼能否单药或联合其他药物作为ALK+ALCL的一线治疗方案,还需要进一步的临床研究证据支持。

Patients with anaplastic lymphoma kinase-positive(ALK+)anaplastic large cell lymphoma(ALCL)respond well to anthracycline-based conventional chemotherapy,with overall response rate of 90%,and 5-year overall survival(OS)rates of 70%-90%.But relapse or refractory patients have a dismal outcome.Crizotinib,an ALK targeted inhibitor,provides the possibility of controlling and curing of ALK+ALCL due to obvious therapeutic effect and slight adverse reactions,and could be used as a bridging strategy and maintenance with hematopoietic stem cells transplantation(HSCT).But the possibility of recurrence after interrupting treatment should be wary.Although crizotinib represents significance in ALK+ALCL,the drug resistance limits its clinical application.In the future,whether crizotinib can be used as the first-line treatment for ALK+ALCL with a single drug or in combination with other drugs requires further clinical research to support.