芦可替尼治疗EB病毒相关淋巴组织增殖性疾病的研究新进展

Research advances of ruxolitinib in treatment of Epstein-Barr virus-lymphoproliferative diseases

芦可替尼是一种强效选择性Janus激酶(JAK)1/2抑制剂,分别于2011和2012年获得美国食品与药品管理局(FDA)和欧洲药品管理局(EMA)批准用于治疗骨髓纤维化(MF),并于2014年被批准用于治疗羟基脲耐药或者不耐受的真性红细胞增多症(PV)。EB病毒相关淋巴组织增殖性疾病(EBV-LPD)是EB病毒(EBV)持续获得性感染导致的一组疾病。近年来,芦可替尼应用于慢性活动性EBV感染(CAEBV)和EBV相关噬血细胞性淋巴组织细胞增多症(EBV-HLH)等淋巴组织增殖性疾病(LPD)的治疗取得了新进展,为EBV-LPD患者提供新的治疗选择。旨在为芦可替尼的临床应用提供参考,笔者就芦可替尼在CAEBV、EBV-HLH中的临床应用及该药的不良反应和禁忌证进行阐述。

Ruxolitinib is a potential and selective inhibitor of Janus kinase(JAK)1 and JAK2,it has been approved for treatment of myelofibrosis(MF)by the United States Food and Drug Administration(FDA)in 2011 and the European Medicines Agency(EMA)in 2012,followed by the approval for treatment of hydroxyurea-resistant or-intolerant polycythemia vera(PV)in 2014.Epstein-barr virus-lymphoproliferative diseases(EBV-LPD)are a group of diseases caused by persistent acquired infection of Epstein-Barr virus(EBV).Ruxolitinib has achieved exciting clinical results in treatment of chronic active EBV infection(CAEBV),EBV associated hemophagocytic lymphohistiocytosis(EBV-HLH)and other lymphoproliferative diseases(LPD)recently,making it a potential choice of treatment for EBV-LPD.In order to provide a reference for clinical application of ruxolitinib,this article intends to summarize advances in ruxolitinib therapy with regard to research and clinical results for CAEBV,EBV-HLH,and its adverse reactions and contraindications.