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司美格鲁肽治疗慢性髓性白血病患者的2型糖尿病:一例病例报告及文献综述

Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature.

作者信息

Zhang Yuchen, Li Anxin

机构信息

Department of Hematology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.

Department of Endocrinology and Metabolism, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, 1 Jiankang Road, Yuzhong District, Chongqing 400014, China.

出版信息

Open Med (Wars). 2025 Apr 23;20(1):20251184. doi: 10.1515/med-2025-1184. eCollection 2025.

Abstract

BACKGROUND

Comorbid type 2 diabetes mellitus (T2DM), severe obesity, and chronic myeloid leukemia (CML) present therapeutic challenges, especially given the limited data on glucagon-like peptide-1 (GLP-1) receptor agonists in this setting.

METHODS

We describe a 33-year-old female with poorly controlled T2DM (HbA1c 10.7%), severe obesity (BMI 47.05 kg/m), and stable CML on tyrosine kinase inhibitor therapy. She received once-weekly semaglutide (0.5-1.5 mg) for 6 months, alongside insulin glargine and dapagliflozin/metformin. Clinical, biochemical, and molecular parameters were monitored.

RESULTS

After 6 months, her HbA1c declined from 10.7 to 5.5%, fasting plasma glucose from 16.2 to 5.3 mmol/L, and body weight decreased by 18 kg. Lipid parameters improved, and molecular analysis confirmed continued CML remission (undetectable BCR-ABL1). The patient experienced only mild, transient gastrointestinal side effects.

CONCLUSION

In this complex case, semaglutide proved safe and effective for achieving glycemic control and weight reduction without compromising CML stability. These findings suggest that GLP-1 receptor agonists may be a viable therapeutic option for patients with coexisting T2DM, severe obesity, and stable CML, warranting further investigation in broader populations.

摘要

背景

2型糖尿病(T2DM)、重度肥胖和慢性髓性白血病(CML)合并存在时带来了治疗挑战,尤其是考虑到在这种情况下关于胰高血糖素样肽-1(GLP-1)受体激动剂的数据有限。

方法

我们描述了一名33岁女性,其T2DM控制不佳(糖化血红蛋白[HbA1c]为10.7%),患有重度肥胖(体重指数[BMI]为47.05kg/m²),正在接受酪氨酸激酶抑制剂治疗的CML病情稳定。她接受了每周一次的司美格鲁肽(0.5 - 1.5mg)治疗,为期6个月,同时使用甘精胰岛素和达格列净/二甲双胍。对临床、生化和分子参数进行了监测。

结果

6个月后,她的HbA1c从10.7%降至5.5%,空腹血糖从16.2mmol/L降至5.3mmol/L,体重减轻了18kg。血脂参数得到改善,分子分析证实CML持续缓解(未检测到BCR-ABL1)。患者仅经历了轻微的、短暂的胃肠道副作用。

结论

在这个复杂病例中,司美格鲁肽被证明在实现血糖控制和体重减轻方面是安全有效的,且不影响CML的稳定性。这些发现表明,GLP-1受体激动剂可能是T2DM、重度肥胖和稳定CML并存患者的一种可行治疗选择,值得在更广泛人群中进一步研究。

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