在一名既往病情进展的慢性淋巴细胞白血病（CLL）患者中，采用蛋氨酸限制联合一线化疗实现完全缓解（CR）
Complete Response (CR) in a Previously-progressing Chronic Lymphocytic Leukemia (CLL) Patient Treated With Methionine Restriction in Combination With First-line Chemotherapy.
作者信息
Morinaga Sei, Han Qinghong, Mizuta Kohei, Kang Byung Mo, Yamamoto Norio, Hayashi Katsuhiro, Kimura Hiroaki, Miwa Shinji, Igarashi Kentaro, Higuchi Takashi, Tsuchiya Hiroyuki, Demura Satoru, Hoffman Robert M
机构信息
AntiCancer Inc., San Diego, CA, U.S.A.
Department of Surgery, University of California, San Diego, CA, U.S.A.
出版信息
Cancer Diagn Progn. 2025 Jan 3;5(1):21-26. doi: 10.21873/cdp.10407. eCollection 2025 Jan-Feb.
BACKGROUND/AIM: Chronic lymphocytic leukemia (CLL) is currently incurable. CLL is characterized by disordered DNA methylation. The aim of the present study was to target methylation with methionine restriction in a patient with progressive CLL.
CASE REPORT
Methionine restriction for the patient was achieved with a low-methionine vegan diet and oral recombinant methioninase (o-rMETase). The patient also received rituximab, once per week for four weeks, and acalabrutinib 100 mg, twice daily (bid) continuously. The patient's white blood cell count decreased by 95% from peak levels and extensive lymphadenopathy disappeared during combination treatment with o-rMETase, rituximab, and acalabrutinib.
CONCLUSION
The combination of methionine restriction and first-line chemotherapy resulted in an apparent complete response (CR) in a CLL patient, a rare event. The duration of the CR will be monitored, and additional CLL patients will be treated similarly in the future.
背景/目的：慢性淋巴细胞白血病（CLL）目前无法治愈。CLL的特征是DNA甲基化紊乱。本研究的目的是在一名进行性CLL患者中通过蛋氨酸限制来靶向甲基化。
病例报告
通过低蛋氨酸纯素饮食和口服重组蛋氨酸酶（o-rMETase）实现了对该患者的蛋氨酸限制。该患者还接受了利妥昔单抗治疗，每周一次，共四周，以及阿卡拉布替尼100毫克，每日两次（bid）持续服用。在联合使用o-rMETase、利妥昔单抗和阿卡拉布替尼治疗期间，患者的白细胞计数从峰值水平下降了95%，广泛的淋巴结病消失。
结论
蛋氨酸限制与一线化疗相结合，在一名CLL患者中产生了明显的完全缓解（CR），这是一个罕见的事件。将监测CR的持续时间，未来将对更多CLL患者进行类似治疗。
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