Zhonghua Xue Ye Xue Za Zhi. 2025 May 14;46(5):410-416. doi: 10.3760/cma.j.cn121090-20250304-00110.
The mainstay of treatment for hemophilia B is Factor Ⅸ or non-factor drug therapy; however, as the disease is incurable, lifelong treatment is required. In recent years, gene therapy for hemophilia B has advanced significantly, with three adeno-associated virus (AAV) vector-based gene therapy products receiving market authorization globally. Among these, Palbociclib was recently approved in China. AAV vector gene therapy is characterized by its irreversible post-treatment effects and potential for long-term efficacy; however, suboptimal efficacy or loss of efficacy has been observed in some cases during early clinical trials. Eligibility for AAV vector gene therapy primarily depends on several factors, including patient diagnostic subtype, age, inhibitor status, AAV capsid antibody titer, and the preferences of the patient and/or their family. Given that AAV vector-based gene therapy for hemophilia has become an accessible frontier treatment, the Thrombosis and Hemostasis Group of the Chinese Society of Hematology, Chinese Medical Association, and the Hemophilia Treatment Center Collaborative Network of China have jointly formulated this guidance. This guidance aims to standardize operational procedures and follow-up recommendations, ensuring that patients receive standardized management when undergoing this novel therapeutic approach.
乙型血友病的主要治疗方法是使用凝血因子Ⅸ或非因子药物疗法;然而,由于该疾病无法治愈,因此需要终身治疗。近年来,乙型血友病的基因治疗取得了显著进展,全球有三种基于腺相关病毒(AAV)载体的基因治疗产品获得了市场授权。其中,帕博西尼最近在中国获批。AAV载体基因治疗的特点是治疗后效果不可逆且具有长期疗效的潜力;然而,在早期临床试验中,一些病例出现了疗效欠佳或疗效丧失的情况。AAV载体基因治疗的适用性主要取决于几个因素,包括患者的诊断亚型、年龄、抑制物状态、AAV衣壳抗体滴度以及患者和/或其家属的偏好。鉴于基于AAV载体的血友病基因治疗已成为一种可及的前沿治疗方法,中华医学会血液学分会血栓与止血学组和中国血友病治疗中心协作网络联合制定了本指南。本指南旨在规范操作程序和随访建议,确保患者在接受这种新型治疗方法时得到标准化管理。