以维奈克拉为基础方案治疗急性髓系白血病的临床观察

Clinical observation of venetoclax-based treatment regimens for acute myeloid leukemia

目的探讨以维奈克拉(VEN)为基础的方案治疗急性髓系白血病(AML)的效果及安全性。方法回顾性分析上海交通大学医学院附属瑞金医院北部院区2021年1月至12月收治的41例接受VEN联合方案治疗的AML患者临床资料。患者治疗方案包括VEN+去甲基化药物±基因突变抑制剂或VEN+化疗,中位疗程数为2个(1~5个)。结果所有患者中位年龄为60岁(18~73岁),男性24例,女性17例。41例患者中,1个疗程后22例(53.7%)获得完全缓解(CR)或血细胞计数未完全恢复的完全缓解(CRi),其中5例微小残留病(MRD)阴性;2个疗程后,17例可评估疗效的患者中7例MRD阴性。20例复发、难治患者中,1个疗程后CR/CRi 9例,其中1例MRD阴性;21例初治、复治患者中,1个疗程后CR/CRi 13例,部分缓解1例,其中4例MRD阴性。结论以VEN为基础的方案治疗AML缓解率较高,且不良反应可耐受。

Objective To investigate clinical efficacy and safety of venetoclax(VEN)-based regimens in the treatment of acute myeloid leukemia(AML).Methods The clinical data of 41 AML patients treated with venetoclax-based regimens from January 2021 to December 2021 in Ruijin Hospital North of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed.The treatment regimens included VEN+demethylating drugs±gene mutation inhibitors or VEN+chemotherapy with a median number of 2 courses(1-5 courses).Results The median age of all patients was 60 years(18-73 years),and there were 24 males and 17 females.After 1 course of VEN-based therapy,22(53.7%)patients achieved complete remission(CR)or morphological complete remission without complete blood count recovery(CRi),including 5 patients achieving minimal residual disease(MRD)negative.After 2 courses of treatment,of 17 patients available for efficacy evaluation,7 patients achieved MRD negative.Among 20 relapsed/refractory AML patients,9 cases achieved CR/CRi after 1 course of treatment,of which 1 patient had MRD negative.Among 21 patients initially treated and re-treated,13 cases achieved CR/CRi and 1 case achieved partial remission after 1 course of treatment,of which 4 cases had MRD negative.Conclusions VEN-based treatment regimens for AML have a high remission rate and tolerable adverse effects.