维奈克拉在复发 难治性急性髓细胞白血病治疗中的应用

Application of venetoclax in the treatment of relapsed/refractory acute myeloid leukemia

复发/难治性急性髓细胞白血病(relapsed/refractory acute myeloid leukemia,R/R AML)患者预后差、死亡率高,是AML治疗的难点之一。BCL-2抑制剂维奈克拉在2018年被美国食品药品监督管理局(FDA)批准用于治疗老年或不能耐受强化治疗的AML患者。近年来,含维奈克拉的方案用于治疗R/R AML展现出一定的疗效,包括联合去甲基化药物、化疗药物、分子抑制剂和桥接同种异基因造血干细胞移植(allogenic hematopoietic stem cell transplantation,allo-HSCT)。此外,allo-HSCT后衔接维奈克拉维持治疗可有效预防AML移植后复发,并能够延长复发患者的生存期。维奈克拉的不良反应发生率低,患者对其具有较好的耐受性。本文主要围绕维奈克拉用于R/R AML的治疗疗效和不良反应的最新进展进行综述。

Poor prognosis and high mortality rates are frequently observed in patients with relapsed/refractory acute myeloid leukemia(R/R AML),making it a hard-to-cure disease.Venetoclax,a BCL-2 inhibitor,was approved for treating newly diagnosed AML in medically unfit adults and patients aged over 75 years.Recently,venetoclax combined with hypomethylating agents,chemotherapy,molecule inhibitors,and allogenic hematopoietic stem cell transplantation(allo-HSCT)has demonstrated promising prospects in treating R/R AML.Maintenance therapy with venetoclax after allo-HSCT was effective in preventing post-transplant relapse and increasing patients’survival.Many clinical studies have also reported the safety of venetoclax because of its high tolerability and low incidence of associated adverse events.This review reports the latest clinical progress on venetoclax treatment for R/R AML and its associated adverse events.