Tao Y, Xu Y L, Wang S, Wang L, Zhao W L
Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Zhonghua Xue Ye Xue Za Zhi. 2023 Jun 14;44(6):490-494. doi: 10.3760/cma.j.issn.0253-2727.2023.06.008.
To investigate the efficacy and safety of Bruton tyrosine kinase inhibitors (BTKi) ibrutinib or zanubrutinib monotherapy in newly diagnosed patients with Waldenström macroglobulinemia (WM) . The efficacy and adverse effects of 58 patients with newly diagnosed WM receiving BTKi monotherapy in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were analyzed retrospectively from January 2018 to August 2022. The response of 55 patients may be examined. Forty patients received ibrutinib monotherapy for a median of 15 months, with an overall response rate (ORR) of 85%, a main remission rate (MRR) of 70%, and a very good partial remission (VGPR) rate of 10%. Fifteen patients received zanubrutinib monotherapy for a median of 13 months, with an ORR of 93%, an MRR of 73%, and a VGPR rate of 0%. For various reasons, 10 patients were converted from ibrutinib to zanubrutinib. Ibrutinib treatment lasted an average of 7.5 months before conversion. The median duration of zanubrutinib therapy after conversion was 3.5 months. The ORRs before and after conversion were 90% and 100%, MRRs were 80% and 80%, and VGPR rates were 10% and 50%, respectively. After a median of 16 months, the 24-month progression-free survival (PFS) rate of patients who received both BTKi was 86%. PFS did not differ statistically across individuals with low, medium, and high-risk ISS scores (=0.998). All of the patients survived. The most common side effects of BTKi were neutropenia and thrombocytopenia, which occurred in 12% and 10% of all patients, respectively. Ibrutinib accounts for 5% of atrial fibrillation, and zanubrutinib has a 7% risk of bleeding. In treating WM, ibrutinib or zanubrutinib provides good efficacy and tolerable adverse effects.
研究布鲁顿酪氨酸激酶抑制剂（BTKi）伊布替尼或泽布替尼单药治疗初诊华氏巨球蛋白血症（WM）患者的疗效和安全性。回顾性分析2018年1月至2022年8月在上海交通大学医学院附属瑞金医院接受BTKi单药治疗的58例初诊WM患者的疗效和不良反应。可对55例患者的反应进行检查。40例患者接受伊布替尼单药治疗，中位治疗时间为15个月，总缓解率（ORR）为85%，主要缓解率（MRR）为70%，非常好的部分缓解（VGPR）率为10%。15例患者接受泽布替尼单药治疗，中位治疗时间为13个月，ORR为93%，MRR为73%，VGPR率为0%。由于各种原因，10例患者从伊布替尼转换为泽布替尼。转换前伊布替尼治疗平均持续7.5个月。转换后泽布替尼治疗的中位持续时间为3.5个月。转换前后的ORR分别为90%和100%，MRR分别为80%和80%，VGPR率分别为10%和50%。中位16个月后，接受两种BTKi治疗的患者24个月无进展生存期（PFS）率为86%。不同国际分期系统（ISS）低、中、高风险评分的患者PFS无统计学差异（=0.998）。所有患者均存活。BTKi最常见的副作用是中性粒细胞减少和血小板减少，分别发生在所有患者的12%和10%中。伊布替尼导致心房颤动的比例为5%，泽布替尼有7%的出血风险。在治疗WM方面，伊布替尼或泽布替尼疗效良好，不良反应可耐受。
