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Observation on the Clinical Effect of Applying Venetoclax Combined with Demethylation Drug Therapy in Patients with Acute Myeloid Leukemia
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作者 Ben Niu Limin Hou 《Journal of Clinical and Nursing Research》 2024年第4期248-252,共5页
Objective: To investigate the therapeutic effect of applying venetoclax combined with demethylating drugs in treating patients with acute myeloid leukemia (AML). Methods: Eighty cases of AML patients treated with vene... Objective: To investigate the therapeutic effect of applying venetoclax combined with demethylating drugs in treating patients with acute myeloid leukemia (AML). Methods: Eighty cases of AML patients treated with venetoclax combined with demethylating drugs in our hospital were selected from March 2021 to March 2024, including 40 cases of primary treatment patients and 40 cases of relapsed and refractory patients. The efficacy and safety of the combined drug therapy was analyzed. Results: The primary treatment group was presented with a complete remission (CR) rate of 40.5%, partial remission (PR) rate of 47.50%, no response (NR) rate of 12.50%, and a remission rate of 87.50%. The relapsed- refractory group was presented with a CR rate of 37.50%, PR rate of 42.50%, NR rate of 17.50%, and a remission rate of 87.50%. There was no statistical significance between the groups (P > 0.05). The hematological adverse reactions of the combined treatment for AML were leukopenia and the non-hematological adverse reactions were mainly infections, with an incidence rate of 87.50%. Conclusion: The efficacy of venetoclax combined with demethylating drugs in AML was remarkable and the treatment regimen can be adjusted according to the treatment-resistant response. 展开更多
关键词 Acute myeloid leukemia Venetoclax Demethylating drugs Combination therapy EFFICACY
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Chidamide,Decitabine,Cytarabine,Aclarubicin,and Granulocyte Colony-stimulating Factor Therapy for Patients with Relapsed/Refractory Acute Myeloid Leukemia:A Retrospective Study from a Single-Center
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作者 Fan-cong KONG Ling QI +3 位作者 Yu-lan ZHOU Min YU Wen-feng HUANG Fei LI 《Current Medical Science》 SCIE CAS 2023年第6期1151-1161,共11页
Objective Preclinical evidence and clinical trials have suggested synergistic effects of epigenetic modifiers in combination with cytotoxic agents for the treatment of leukemia.However,their efficacy in patients with ... Objective Preclinical evidence and clinical trials have suggested synergistic effects of epigenetic modifiers in combination with cytotoxic agents for the treatment of leukemia.However,their efficacy in patients with relapsed/refractory acute myeloid leukemia(R/R AML)remains unclear.Methods Clinical data of R/R AML patients who received a CDCAG regimen(chidamide,decitabine,cytarabine,aclarubicin,and granulocyte colony-stimulating factor)from July 1,2018 to October 31,2021 at our center were retrospectively assessed,and the safety and efficacy of the CDCAG regimen were evaluated.Patients were followed up until November 30,2021,with a median follow-up of 21.6 months(95%CI:10.0–33.2 months).Results A total of 67 patients were enrolled.Two patients died within 3 weeks after the initiation,and therefore only 65 patients underwent the assement for clinical response and survival.It was found that 56.9%patients achieved complete remission with a median overall survival(OS)of 9.6 months.The median OS of responders was 25.9 months,while that of non-responders was 5.0 months(P<0.0001).Patients with gene mutations had a superior overall response rate(ORR)(80.4%vs.45.5%,P=0.043)compared to those without gene mutations.The presence of DNA methyltransferase 3 A(DNMT3A),ten-eleven translocation-2(TET2),and isocitrate dehydrogenase 1/2(IDH1/2)mutations did not affect the response rate(88.2%vs.68.9%,P=0.220)and reflected a better OS(not attained vs.9.0 months,P=0.05).The most common non-hematologic adverse events were pulmonary infection(73.1%),followed by febrile neutropenia(23.9%)and sepsis(19.4%).Conclusions The CDCAG regimen was effective and well-tolerated in R/R AML patients,increasing the potential for allogeneic hematopoietic stem cell transplantation.Moreover,patients with DNMT3A,TET2,and IDH1/2 mutations might benefit from this regimen. 展开更多
关键词 relapsed/refractory acute myeloid leukemia histone deacetylase inhibitor DNA methyltransferase inhibitor salvage therapy
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Non-canonical BRAF variants and rearrangements in hairy cell leukemia
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作者 STEPHEN E.LANGABEER 《Oncology Research》 SCIE 2024年第9期1423-1427,共5页
Hairy cell leukemia(HCL)is an uncommon mature B-cell malignancy characterized by a typical morphology,immunophenotype,and clinical profile.The vast majority of HCL patients harbor the canonical BRAF V600E mutation whi... Hairy cell leukemia(HCL)is an uncommon mature B-cell malignancy characterized by a typical morphology,immunophenotype,and clinical profile.The vast majority of HCL patients harbor the canonical BRAF V600E mutation which has become a rationalized target of the subsequently deregulated RAS-RAF-MEK-MAPK signaling pathway in HCL patients who have relapsed or who are refractory to front-line therapy.However,several HCL patients with a classical phenotype display non-canonical BRAF mutations or rearrangements.These include sequence variants within alternative exons and an oncogenic fusion with the IGH gene.Care must be taken in the molecular diagnostic work-up of patients with typical HCL but without the BRAF V600E to include investigation of these uncommon mechanisms.Identification,functional characterization,and reporting of further such patients is likely to provide insights into the pathogenesis of HCL and enable rational selection of targeted inhibitors in such patients if required. 展开更多
关键词 Hairy cell leukemia BRAF Molecular diagnostics Targeted therapy
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Empathetic nursing with mindful cognitive therapy for fatigue,depression,and negative emotions in leukemia patients undergoing long-term chemotherapy 被引量:2
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作者 Ying-Ying Lu Xiao-Min Lu +3 位作者 Chun-Yan Shao Chen-Chen Wang Ting-Ting Xu Bei-Lei Zhang 《World Journal of Clinical Cases》 SCIE 2022年第6期1826-1833,共8页
BACKGROUND Leukemia is a broad term for blood cell cancer.Leukemia is divided into acute or chronic,depending on cell differentiation.Leukemia patients are prone to adverse reactions during chemotherapy,such as anxiet... BACKGROUND Leukemia is a broad term for blood cell cancer.Leukemia is divided into acute or chronic,depending on cell differentiation.Leukemia patients are prone to adverse reactions during chemotherapy,such as anxiety,depression,and even suicide,affecting prognosis.As a nursing model developed by three well-known cognitive psychologists,empathetic nursing with mindfulness cognitive therapy(ENMCT)can effectively reduce anxiety and depression and improve the quality of life in patients with chronic disease.AIM To explore the effect of ENMCT on cancer-induced fatigue,hope level,and negative emotions in patients with long-term leukemia chemotherapy.METHODS A total of 103 patients with long-term leukemia chemotherapy diagnosed and treated in our hospital from July 2017 to October 2019 were enrolled and randomly assigned to observation and control groups using the random number table approach.Fifty-one patients in the control group received routine nursing,while 52 patients in the observation group received empathic nursing with mindfulness cognitive therapy.After three months of nursing care,cancerinduced fatigue was measured with the Piper Fatigue Scale(PFS),hope level with the Herth Hope Index(HHI),and negative emotion with the Hamilton Anxiety Scale(HAMA)/Hamilton Depression Scale(HAMD).Self-management(Chinese Strategies Used by People to Promote Health)was also recorded.RESULTS The observation group’s total scores in behavior,cognition,emotion,feeling,and PFS were lower than the control group after the intervention(P<0.05).Keeping close contact with others,the attitude of taking positive actions,the attitude toward reality and future,and the total HHI score were higher in the observation group than the control group(P<0.05).The observation group’s HAMA and HAMD scores were lower than the control group(P<0.05).The observation group’s positive attitude,self-decision,and self-relief scores were greater than the control group(P<0.05).CONCLUSION Empathetic nursing with cognitive mindfulness therapy is beneficial in improving cancer-related fatigue,negative emotions,expectation level,and self-management ability in patients with longterm leukemia chemotherapy. 展开更多
关键词 Mindfulness-based cognitive therapy Empathetic nursing leukemia CHEMOtherapy Cancerinduced fatigue Hope level Negative emotions
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Therapy-Related Acute Myeloid Leukemia in A Primary Pulmonary Leiomyosarcoma Patient with Skin Metastasis 被引量:2
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作者 Yan Ma Bo-bin Chen +4 位作者 Xiao-ping Xu Guo-wei Lin Yuan Ji Sujie Akesu Haiying Zen 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2011年第3期236-238,共3页
Primary pulmonary leiomyosarcoma (LMS) is a very unusual tumor.Although LMS has well-known metastatic potential,cutaneous metastasis is a remarkably uncommon.Exposure to cytotoxic agents could lead to "therapy-rela... Primary pulmonary leiomyosarcoma (LMS) is a very unusual tumor.Although LMS has well-known metastatic potential,cutaneous metastasis is a remarkably uncommon.Exposure to cytotoxic agents could lead to "therapy-related myeloid neoplasm" (t-MN).Starting from 2008,the World Health Organization (WHO) has adopted the term to cover the spectrum of malignant diseases previously known as therapy-related acute myeloid leukemia (t-AML),therapy-related myelodysplastic syndrome (t-MDS) and therapy-related myelodysplastic/myelo-proliferative neoplasm (t-MDS/MPN).We described the onset of t-MDS and progression to t-AML in one case diagnosed as primary pulmonary LMS with cutaneous metastasis.This patient achieved complete remission (CR) after three courses of IA regimen chemotherapy (idarubicin 5 mg/d,d 1-3;cytarabine 100 mg/d,d 1-5) and 1 course of HA chemotherapy regimen (homoharringtonine 3 mg/d,d 1-3;cytarabine 100 mg/d,d 1-7).This case presents the natural course of therapy-related neoplasm and provides therapeutic experience for t-AML. 展开更多
关键词 therapy-related myelodysplastic syndrome therapy-related acute myeloid leukemia LEIOMYOSARCOMA METASTASIS SKIN
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Targeting leukemia stem cells:The new goal of therapy in adult acute myeloid leukemia
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作者 Xavier Thomas 《World Journal of Stem Cells》 SCIE CAS 2009年第1期49-54,共6页
The most popular view of hematopoietic cell lineage organization is that of complex reactive or adaptative systems.Leukemia contains a subpopulation of cells that display characteristics of stem cells.These cells main... The most popular view of hematopoietic cell lineage organization is that of complex reactive or adaptative systems.Leukemia contains a subpopulation of cells that display characteristics of stem cells.These cells maintain tumor growth.The properties of leukemia stem cells indicate that current conventional chemotherapy, directed against the bulk of the tumor,will not be effective.Leukemia stem cells are quiescent and do not respond to cell cycle-specific cytotoxic agents used to treat leukemia and thus contribute to treatment failure. New strategies are required that specifically target this malignant stem cell population. 展开更多
关键词 Acute MYELOID leukemia leukemia stem cells TARGETED therapy Prognosis
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Breathing adapted radiation therapy for leukemia relapse in the breast: A case report
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作者 Omer Sager Ferrat Dincoglan +7 位作者 Selcuk Demiral Bora Uysal Hakan Gamsiz Fatih Ozcan Onurhan Colak Yelda Elcim Bahar Dirican Murat Beyzadeoglu 《World Journal of Clinical Oncology》 CAS 2019年第11期369-374,共6页
BACKGROUND Infiltration of the breast by leukemic cells is uncommon but may manifest as an oncological emergency requiring prompt management.Extramedullary relapse of T-cell acute lymphoblastic leukemia(T-ALL)within t... BACKGROUND Infiltration of the breast by leukemic cells is uncommon but may manifest as an oncological emergency requiring prompt management.Extramedullary relapse of T-cell acute lymphoblastic leukemia(T-ALL)within the breast is exceedingly rare and there is paucity of data in the literature regarding this entity.No consensus exists on management of isolated extramedullary breast relapses of T-ALL.Herein,we report a case of isolated extramedullary breast relapse of T-ALL treated with breathing adapted radiation therapy(BART)using the active breathing control(ABC)system.CASE SUMMARY The patient was a 33-year-old female with diagnosis of T-ALL.She received intensive systemic chemotherapy that resulted in complete remission of her disease,and then underwent allogeneic hematopoietic stem cell transplantation.After a 15 mo period without symptoms and signs of progression,the patient presented with palpable masses in both breasts.She complained from severe pain and swelling of the breasts.Imaging workup showed bilateral breast lesions,and diagnosis of breast infiltration by leukemic cells was confirmed after immunohistopathological evaluation.The patient suffering from severe pain,discomfort,and swelling of both breasts due to leukemic infiltration was referred to the Radiation Oncology Department for symptomatic palliation.Whole breast irradiation was delivered to both breasts of the patient with BART using the ABC system.The patient had complete resolution of her symptoms after treatment with BART.CONCLUSION BART with the ABC system resulted in complete resolution of the patient’s symptoms due to leukemic infiltration of both breasts with T-ALL.This contemporary treatment technique should be preferred for radiotherapeutic management of patients with leukemic infiltration of the breasts to achieve effective symptomatic palliation. 展开更多
关键词 T-CELL acute LYMPHOBLASTIC leukemia BREAST RELAPSE BREATHING adapted radiation therapy Active BREATHING control Case report
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OPTIMIZATIONS FOR 5-AMINOLEVULINIC ACID BASED PHOTODYNAMIC THERAPY IN PURGING LEUKEMIA CELL HL60
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作者 张苏娟 张镇西 张宝琴 《Journal of Pharmaceutical Analysis》 SCIE CAS 2005年第2期41-46,共6页
Objective To optimize experimental parameters for the photosensitization of 5-aminolevulinic acid (ALA) in promyelocytic leukemia cell HL60 and compare them with normal human peripheral blood mononuclear cell (PBMC). ... Objective To optimize experimental parameters for the photosensitization of 5-aminolevulinic acid (ALA) in promyelocytic leukemia cell HL60 and compare them with normal human peripheral blood mononuclear cell (PBMC). Methods ALA incubation time, wavelength applied to irradiate, concentration of ALA incubated, irradiation fluence may modulate the effect of 5-aminolevulinic acid based Photodynamic Therapy (ALA-PDT).The high-pressure mercury lamps of 400W served as light source, the interference filter of 410nm, 432nm, 545nm, 577nm were used to select the specific wavelength. Fluorescence microscope was used to detect the fluorescence intensity and location of protoporphyrin IX (PpIX) endogenously produced by ALA. MTT assay was used to measure the survival of cell. Flow cytometry with ANNEXIN V FITC kit (contains annexin V FITC, binding buffer and PI) was used to detect the mode of cell death. Results ① 1mmol/L ALA incubated 1×105/mL HL60 cell line for 4 hours, the maximum fluorescence of ALA induced PpIX was detected in cytomembrane. ② Irradiated with 410nm for 14.4J/cm2 can result in the minimum survivability of HL60 cell. ③ The main mode of HL60 cell death caused by ALA-PDT is necrosis. Conclusion ALA for 1mmol/L, 4 hours for dark incubation time, 410nm for irradiation wavelength, 14.4J/cm2 for irradiation fluence were the optimal parameters to selectively eliminate promyelocytic leukemia cell HL60 by ALA based PDT. The photosensitization of ALA based PDT caused the necrosis of HL60 cell, so it could be used for inactivation of certain leukemia cells. 展开更多
关键词 5-aminolevulinic acid(ALA) photodynamic therapy(PDT) leukemia cell HL60 optimal parameter
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ENHANCED ANTITUMOR EFFECTS OF SUICIDE GENETHERAPY BY SIMULTANEOUS TRANSFER OF GM CSF GENE IN LEUKEMIABEARING MICE
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作者 鞠佃文 曹雪涛 +3 位作者 于益芝 陶群 王宝梅 万涛 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 1998年第2期3-7,共5页
In the present report, antitumor effect of combined transfer of suicide gene and cytokine gene was studied. Adenovirus engineered to express E. Coli. Cytosine deaminase (AdCD) and/or adenovirus engineered to express m... In the present report, antitumor effect of combined transfer of suicide gene and cytokine gene was studied. Adenovirus engineered to express E. Coli. Cytosine deaminase (AdCD) and/or adenovirus engineered to express murine granulocytemacrophage colonystimulating factor (AdGMCSF) were used for the treatment of leukemiabearing mice. The mice were inoculated s.c. with FBL3 erythroleukemia cells and 3 days later received intratumoral injection of AdCD in the presence or absence of AdGMCSF followed by intraperitoneal 5fluorocytosine (5FC) treatment. The results demonstrated that mice received combined therapy of AdCD/5FC and AdGMCSF developed tumors most slowly and survived much longer when compared with mice treated with AdCD/5FC alone, AdGMCSF alone, AdlacZ/5FC or PBS. Combined transfer of CD gene and GMCSF gene achieved higher specific CTL activity than control therapies. Pathological examination illustrated that the tumor mass showed obvious necrosis and inflammatory cell infiltration in mice after combined therapy. The results demonstrated that combined transfer of suicide gene and cytokine gene could synergistically inhibit the growth of leukemia in mice and induce antitumor immunity of the host. The combination therapy might be a potential approach for cancer gene therapy. 展开更多
关键词 Cytosine deaminase Suicide gene Gene therapy Adenovirus Granulocyte macrophage colonystimulating factor leukemia
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The combination therapy of imatinib and dasatinib achieves long-term molecular response in two imatinib-resistant and dasatinibintolerant patients with advanced chronic myeloid leukemia
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作者 Yu Zhu Liangqin Pan +4 位作者 Ming Hong Weixing Liu Chun Qiao Jianyong Li Sixuan Qian 《The Journal of Biomedical Research》 CAS CSCD 2016年第6期525-528,共4页
For patients with chronic myeloid leukemia(CML) failing imatinib therapy,second-generation tyrosine kinase inhibitors(TKIs) are recommended.Here,we describe two patients with advanced CML who failed imatinib thera... For patients with chronic myeloid leukemia(CML) failing imatinib therapy,second-generation tyrosine kinase inhibitors(TKIs) are recommended.Here,we describe two patients with advanced CML who failed imatinib therapy and did not tolerate the recommended dose of dasatinib,but then achieved a major molecular response with the combination of imatinib and dasatinib with no significant extramedullar/ toxicity.Our observations suggest that combination of TKIs may provide an additive/synergistic antileukemic effect. 展开更多
关键词 chronic myeloid leukemia tyrosine kinase inhibitors resistance combined therapy
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HUMAN GENOME RESEARCH & LEUKEMIA THERAPY IN CHINA
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作者 Chen Zhu(Ruijin Hospital attached to Shanghai Second Medical University, Shanghai Institute of Hematology & Key Laboratory of Human Genome Research under the Ministry of Public Hygiene and Shanghai Municipality) , 《Bulletin of the Chinese Academy of Sciences》 1997年第3期228-233,共6页
Ⅰ. HGP AND HUMAN GENOME SCIENCE IN CHINA The HGP, standing for "human genome project," is one of the basic research programs of vital importance in life science, now underway in a worldwide scope. Its signi... Ⅰ. HGP AND HUMAN GENOME SCIENCE IN CHINA The HGP, standing for "human genome project," is one of the basic research programs of vital importance in life science, now underway in a worldwide scope. Its significance is never to be overestimated when we place any stress on it. As a matter of fact, it will provide an invaluable tool to reveal the essence of human life by 展开更多
关键词 ATRA PML HUMAN GENOME RESEARCH leukemia therapy IN CHINA HGP GENE
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Study on the Clinical Efficacy of Megestrol Acetate Dispersible Tablets in Adjuvant Treatment of Acute Leukemia
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作者 Ben Niu Lan Li 《Journal of Clinical and Nursing Research》 2023年第4期191-194,共4页
Objective:To analyze the clinical efficacy of megestrol acetate dispersible tablets in the adjuvant treatment of acute leukemia.Methods:80 patients with acute leukemia admitted from December 2021 to December 2022 were... Objective:To analyze the clinical efficacy of megestrol acetate dispersible tablets in the adjuvant treatment of acute leukemia.Methods:80 patients with acute leukemia admitted from December 2021 to December 2022 were randomly divided into two groups.The control group underwent chemotherapy,and the observation group took megestrol acetate dispersible tablets and underwent chemotherapy.The effect of the treatments were evaluated by analyzing the albumin(Alb)and prealbumin(Palb)indicators,and the adverse reactions were observed.Results:There was no significant difference in Alb and Palb indexes between the two groups before treatment(P>0.05).After treatment,Alb and Palb indexes in the observation group were greater than those in the control group(P<0.05).The incidence of adverse reactions in the control group was 20.00%,which was significantly higher than the observation group(5.00%),with P<0.05.Conclusion:The combination of megestrol acetate dispersible tablets and chemotherapy is more effective in treating patients with acute leukemia,and the Alb and Palb indexes can be optimized.Besides,there are fewer adverse reactions,which means that the treatment is relatively safe. 展开更多
关键词 Acute leukemia Megestrol acetate dispersible tablets Adjuvant therapy
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血清CysC、β_(2)-MG与急性髓系白血病患者去甲基化治疗效果的关系
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作者 张彩虹 宿瑞俊 +1 位作者 黄彬涛 王志玲 《中国实验血液学杂志》 CAS CSCD 北大核心 2024年第4期1005-1010,共6页
目的:分析血清胱抑素C(Cys C)、β_(2)-微球蛋白(β_(2)-MG)与急性髓系白血病(AML)患者去甲基化治疗效果的关系。方法:使用前瞻性队列研究方法,纳入2019年2月-2022年1月内蒙古医科大学附属医院收治的98例AML患者进行研究,全部患者均接... 目的:分析血清胱抑素C(Cys C)、β_(2)-微球蛋白(β_(2)-MG)与急性髓系白血病(AML)患者去甲基化治疗效果的关系。方法:使用前瞻性队列研究方法,纳入2019年2月-2022年1月内蒙古医科大学附属医院收治的98例AML患者进行研究,全部患者均接受地西他滨(DAC)+HAG方案治疗,以28 d为1个疗程,治疗3-4疗程。每个疗程结束时评估患者的治疗效果,达到完全缓解(CR)的患者进入巩固治疗,全部疗程结束未达到CR的患者视为治疗失败。治疗前检查项目包括血常规参数、血清Cys C、β_(2)-MG,并统计患者一般临床资料。根据统计结果,使用logistic回归分析血清Cys C、β_(2)-MG与AML患者去甲基化治疗效果的关系;绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评估血清Cys C、β_(2)-MG对AML患者去甲基化治疗效果的预测效能。结果:入组98例AML患者,治疗期间5例被剔除,最终93例患者完成化疗疗程,其中23例初次诱导化疗(1-2疗程)达到CR,再诱导化疗(3-4疗程)后11例达到CR,治疗成功率为36.56%(34/93)。去甲基化治疗失败患者预后不良、预后中等占比高于治疗成功患者,血小板(PLT)、血红蛋白(Hb)水平低于治疗成功患者,血清Cys C、β_(2)-MG表达水平高于治疗成功患者,差异有统计学意义(P<0.05)。logistic回归分析显示,血清Cys C、β_(2)-MG高表达及预后不良是AML患者去甲基化治疗失败的独立危险因素(OR>1,P<0.05)。ROC曲线显示,血清Cys C、β_(2)-MG单独及联合预测AML患者去甲基化治疗效果的AUC值分别为0.788、0.785、0.834。结论:AML患者去甲基化治疗失败与血清Cys C、β_(2)-MG高表达有关,治疗前检测血清Cys C、β_(2)-MG能够预测AML患者去甲基化治疗失败风险。 展开更多
关键词 急性髓系白血病 去甲基化治疗 胱抑素C β_(2)-微球蛋白
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维奈克拉联合阿扎胞苷治疗不耐受强化疗的初治老年急性髓系白血病的临床疗效
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作者 赵慧瑾 金震 +7 位作者 张赟翔 吴敏 郑宇 吴文 沈扬 陈秋生 李军民 陈瑜 《内科理论与实践》 2024年第2期89-94,共6页
目的:总结35例不耐受强化疗的初治老年急性髓系白血病(acute myeloid leukemia,AML)的临床特点,评估维奈克拉(venetoclax,VEN)联合阿扎胞苷(azacytidine,AZA)的疗效及安全性。方法:纳入本院2021年2月至2022年3月间诊断的35例不耐受强化... 目的:总结35例不耐受强化疗的初治老年急性髓系白血病(acute myeloid leukemia,AML)的临床特点,评估维奈克拉(venetoclax,VEN)联合阿扎胞苷(azacytidine,AZA)的疗效及安全性。方法:纳入本院2021年2月至2022年3月间诊断的35例不耐受强化疗的初治老年AML患者,接受VEN+AZA诱导治疗,回顾性分析其临床特征、VEN+AZA诱导的缓解情况及治疗安全性。结果:患者中位年龄68岁,继发AML 9例。所有患者均完成骨髓细胞遗传学及分子生物学评估,其中低危患者10例,中危12例,高危13例。常见的基因突变为DNA甲基转移酶3A(DNA methyltransferase 3A,DNMT3A)(11例)、异柠檬酸脱氢酶1/2(isocitrate dehydrogenase 1/2,IDH1/2)(11例)、TET癌基因家族成员2(ten⁃eleven translocation 2,TET2)(9例)、核仁磷酸蛋白1(nucleophosmin 1,NPM1)(8例)、Fms⁃样酪氨酸激酶3⁃内部串联重复(Fms⁃related tyrosine kinase 3⁃internal tandem duplication,FLT3⁃ITD)(6例)。总完全缓解(complete remission,CR)率65.7%(23例),NPM1、FLT3⁃ITD、IDH1/2突变患者CR率分别为87.5%、66.7%、72.7%。CR患者中总微小残留病变(minimal residual disease,MRD)阴性率73.9%。中位随访时间10.1个月,中位无事件生存(event⁃free survival,EFS)期11.3个月。缓解患者中,相比于MRD阳性患者,MRD阴性患者EFS及总生存(overall survival,OS)期更长(P<0.05)。早期死亡率5.7%,治疗过程中最常见的不良反应为血液学毒性(3~4级中性粒细胞减少31.4%、3~4级血小板减少25.7%、中性粒细胞减少性发热48.6%)及肺部感染(17.1%)。结论:VEN+AZA在不耐受强化疗的初治老年AML中治疗的总缓解率较高。NPM1突变可能提示更高缓解率。MRD转阴患者EFS期及OS期较MRD阳性患者延长,死亡风险下降。VEN+AZA是目前不能耐受强化疗的初治老年AML重要的治疗选择之一。 展开更多
关键词 急性髓系白血病 老年 诱导治疗 不耐受强化化疗 临床疗效
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慢性淋巴细胞白血病靶向治疗的研究进展 被引量:1
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作者 丁艳玲 李杰 +1 位作者 袁军 李燕 《上海交通大学学报(医学版)》 CAS CSCD 北大核心 2024年第2期264-270,共7页
慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)是小B细胞淋巴瘤和白血病的一种,也是B细胞克隆增殖性肿瘤。该病具有明显的异质性,大多数患者的病程趋于惰性,但目前仍不可治愈。异常的信号转导机制是CLL发病机制中不可或缺的。... 慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)是小B细胞淋巴瘤和白血病的一种,也是B细胞克隆增殖性肿瘤。该病具有明显的异质性,大多数患者的病程趋于惰性,但目前仍不可治愈。异常的信号转导机制是CLL发病机制中不可或缺的。在CLL中,常见的异常信号通路包括B细胞受体信号、细胞凋亡、核因子κB(nuclear factor kappa-B,NF-κB)信号以及Notch信号通路等。针对这些信号通路,研发了一系列的靶向药物,如布鲁顿酪氨酸激酶抑制剂(伊布替尼、泽布替尼)、磷酸化磷脂酰肌醇3激酶抑制剂(杜韦利西布)、B细胞淋巴瘤2抑制剂(维奈克拉)等,在临床上显著改变了患者的预后。其他靶向药物如fenebrutinib、nemtabrutinib、厄布利塞等,还有免疫肿瘤学和T细胞工程领域发展的嵌合抗原受体T细胞疗法,目前尚在临床试验阶段。更加个体化的治疗方式正在探索,未来可能成为潜在的治疗选择。该文对CLL领域的相关文献进行梳理,就CLL分子机制及靶向治疗的最新研究进行综述。 展开更多
关键词 慢性淋巴细胞白血病 分子机制 靶向治疗 嵌合抗原受体T细胞治疗
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去甲基化药物联合维奈克拉在急性髓系白血病造血干细胞移植中的应用进展 被引量:1
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作者 高云飞 赵欣 +1 位作者 王勇 刘晓亮 《现代肿瘤医学》 CAS 2024年第10期1929-1934,共6页
移植后复发是导致急性白血病异基因造血干细胞移植(allo-HSCT)失败的主要原因,复发患者的挽救性治疗效果有限,预后往往很差,很少有患者能够长期存活。去甲基化药物(hypomethylating agents, HMAs)联合维奈克拉(Venetoclax, VEN)的治疗... 移植后复发是导致急性白血病异基因造血干细胞移植(allo-HSCT)失败的主要原因,复发患者的挽救性治疗效果有限,预后往往很差,很少有患者能够长期存活。去甲基化药物(hypomethylating agents, HMAs)联合维奈克拉(Venetoclax, VEN)的治疗已经成为指南推荐的对于≥60岁尤其是不适合强化疗的初治急性髓系白血病(acute myeloid leukemia, AML)患者的新标准治疗方案。但关于allo-HSCT过程中HMAs+VEN的联合治疗,目前临床应用较少。本文就二者联合应用于桥接allo-HSCT、移植后复发预防及挽救治疗中的作用作一综述,以阐明其治疗AML移植患者的整体疗效,进一步指导其在allo-HSCT中的临床应用。 展开更多
关键词 去甲基化药物 维奈克拉 联合治疗 急性髓系白血病 异基因造血干细胞移植
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急性白血病异基因造血干细胞移植后的维持治疗研究进展 被引量:1
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作者 杨楚婷 郑雅龄 +1 位作者 吴明(综述) 黄睿(审校) 《中国肿瘤临床》 CAS CSCD 北大核心 2024年第12期635-639,共5页
急性白血病(acute leukemia,AL)是来源于造血干细胞的恶性克隆性疾病,分为急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)和急性髓细胞白血病(acute myeloid leukemia,AML)两大类。异基因造血干细胞移植(allogeneic hematopoiet... 急性白血病(acute leukemia,AL)是来源于造血干细胞的恶性克隆性疾病,分为急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)和急性髓细胞白血病(acute myeloid leukemia,AML)两大类。异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)是AL患者获得长期生存有力的手段,但移植后复发仍然是导致其死亡的主要原因。移植前状态、移植预处理、移植后复发防治均影响移植后的复发。目前,有部分患者移植后维持治疗的研究开展,包括表观遗传学药物、靶向药物、免疫药物等移植后维持治疗。本文主要讨论移植后维持治疗与预后的关系,综述近年来急性白血病allo-HSCT后维持治疗的方法、治疗结局和潜在的不良反应。 展开更多
关键词 急性白血病 异基因造血干细胞移植 维持治疗 靶向治疗 免疫治疗
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国医大师周仲瑛从“伏毒”辨治白血病经验 被引量:1
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作者 江珊 孙萌 +2 位作者 陈潇颖 李天赐 叶放 《上海中医药杂志》 CSCD 2024年第2期62-65,共4页
介绍周仲瑛教授运用“伏毒”理论辨治白血病的经验。认为正虚为白血病发病的前提,毒伏营血、戕伤骨髓为白血病的基本病机,余毒不清、正虚毒恋为白血病复发的关键;治疗始终不离“伏毒”病机,将透毒、解毒、托毒法贯穿疾病治疗的始终。并... 介绍周仲瑛教授运用“伏毒”理论辨治白血病的经验。认为正虚为白血病发病的前提,毒伏营血、戕伤骨髓为白血病的基本病机,余毒不清、正虚毒恋为白血病复发的关键;治疗始终不离“伏毒”病机,将透毒、解毒、托毒法贯穿疾病治疗的始终。并附验案1则。 展开更多
关键词 白血病 伏毒 周仲瑛 名医经验 中医药疗法
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去甲基化药物在慢性粒单核细胞白血病中的临床疗效观察
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作者 李笑 王艳 +4 位作者 郭玉洁 牛志云 马莉 周旭泉 张敬宇 《中国实验血液学杂志》 CSCD 北大核心 2024年第1期257-261,共5页
目的:观察去甲基化药物在慢性粒单核细胞白血病(CMML)中的临床疗效及安全性。方法:回顾性分析2014年2月至2021年6月在河北医科大学第二医院确诊为CMML并应用去甲基化药物治疗的患者的临床资料、疗效指标、生存期及安全性。结果:共有25例... 目的:观察去甲基化药物在慢性粒单核细胞白血病(CMML)中的临床疗效及安全性。方法:回顾性分析2014年2月至2021年6月在河北医科大学第二医院确诊为CMML并应用去甲基化药物治疗的患者的临床资料、疗效指标、生存期及安全性。结果:共有25例CMML患者接受去甲基化药物治疗,18例以地西他滨为基础治疗,7例以阿扎胞苷为基础治疗。其中20例获得应答,7例获得完全缓解(CR),CR患者均以地西他滨为基础治疗,5例CR发生于治疗的前4个疗程。中位随访16.4(9.4-20.5)个月后,4例CR患者进展为急性髓系白血病。25例CMML患者的中位总生存期为17.4个月(95%CI:12.437-22.363)。按照MDAPS、CPSS、CPSS-mol、MMM预后积分系统分别对患者进行危险度分层,仅发现MDAPS预后积分系统不同危险度分层与生存期之间的差异有统计学意义。CMML患者应用去甲基化药物的常见不良反应包括感染、胃肠道反应、血液学毒性、皮肤过敏和肝功能损伤。所有患者给予相应的治疗后,症状均得到改善。结论:去甲基化药物对CMML患者治疗有效,且安全性良好。CR多发生于治疗的前4个疗程,对于无应答的患者,可应用去甲基化药物联合小剂量化疗。去甲基化药物可以延缓病情但并不能阻止CMML的疾病进展。 展开更多
关键词 慢性粒单核细胞白血病 去甲基化药物 完全缓解 总生存期 安全性
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白血病眼部表现及治疗相关眼部不良反应研究进展
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作者 黄泽宇(综述) 陈辉 季敏(审校) 《中华实验眼科杂志》 CAS CSCD 北大核心 2024年第6期587-592,共6页
白血病是血液系统常见的恶性肿瘤,许多患者可有眼部表现,部分患者可因视力损害或眼部病变首诊于眼科。白血病可通过直接浸润或由于贫血、血小板减少、血黏度增高、免疫抑制等间接因素累及眼前节、玻璃体、视网膜、视神经、脉络膜、眼眶... 白血病是血液系统常见的恶性肿瘤,许多患者可有眼部表现,部分患者可因视力损害或眼部病变首诊于眼科。白血病可通过直接浸润或由于贫血、血小板减少、血黏度增高、免疫抑制等间接因素累及眼前节、玻璃体、视网膜、视神经、脉络膜、眼眶等眼组织,特征性眼部表现包括Roths斑、绿色瘤等。不同类型白血病对眼部的损害概率和侵犯部位不尽相同,急性较慢性、髓细胞较淋巴细胞白血病出现眼部病变的概率高。近年来,白血病的治疗取得了较大进展,特别是抗白血病靶向药物、造血干细胞移植的广泛应用等,但白血病患者生存周期明显延长的同时,也可能引起或加重眼部病变,如酪氨酸酶抑制剂类药物可导致眶周水肿、阿糖胞苷具有角膜毒性、甲氨蝶呤引起眼外肌麻痹、造血干细胞移植后干眼高发等,在很大程度上影响到患者的生存质量。因此,重视白血病相关眼病的诊治具有重要的临床意义。本文就白血病的眼部表现及其治疗引起的眼部不良反应进行综述。 展开更多
关键词 白血病 眼部表现 治疗 眼部不良反应 移植物抗宿主病
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