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维奈托克联合低甲基化药物治疗初治 B/髓系混合表型急性白血病和复发/难治性急性髓系白血病:3 例报告。

Venetoclax in Combination with Hypomethylating Agents for the Treatment of Treatment-Naive B/Myeloid Mixed-Phenotype Acute Leukemia and Relapsed/Refractory Acute Myeloid Leukemia: A Report of 3 Cases.

机构信息

Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Chemotherapy. 2022;67(3):178-182. doi: 10.1159/000519882. Epub 2022 Mar 18.

Abstract

B/myeloid mixed-phenotype acute leukemia (MPAL) is an uncommon and aggressive leukemia without well-established treatment guidelines and has an inferior outcome. Relapsed/refractory (R/R) acute myeloid leukemia (AML) that is ineligible for aggressive chemotherapy regimens and allogeneic hematopoietic stem-cell transplantation has an extremely poor prognosis. The novel regimen of venetoclax (VEN) combined with hypomethylating agents (HMAs) has a synergistic therapeutic effect and a tolerable safety profile, which has been officially approved by the US Food and Drug Administration (FDA) for newly diagnosed AML in adults who are 75 years or older or patients precluding intensive induction chemotherapy. For R/R and other rare types of AML, no consensus has been reached on the efficacy of VEN-HMA. In addition, there is no available report on treatment-naive B/myeloid MPAL with VEN-HMA. Herein, we present 3 cases of VEN-HMA in treatment-naive B/myeloid MPAL and R/R AML. Its potential efficacy is worthy of further exploration in future researches.

摘要

B 型髓系混合表型急性白血病(MPAL)是一种罕见且侵袭性的白血病,目前尚无明确的治疗指南,预后较差。不适合强化化疗方案和异基因造血干细胞移植的复发/难治性(R/R)急性髓系白血病(AML)预后极差。新型 venetoclax(VEN)联合低甲基化剂(HMAs)方案具有协同治疗作用和可耐受的安全性特征,已被美国食品和药物管理局(FDA)正式批准用于 75 岁及以上新诊断的 AML 患者或不能进行强化诱导化疗的患者。对于 R/R 和其他罕见类型的 AML,VEN-HMA 的疗效尚未达成共识。此外,尚无关于 VEN-HMA 治疗初治 B 型髓系 MPAL 的可用报告。在此,我们报告了 3 例初治 B 型髓系 MPAL 和 R/R AML 患者接受 VEN-HMA 治疗的情况。其潜在疗效值得在未来的研究中进一步探索。

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