摘要
目的探讨硼替佐米联合常规化疗方案治疗复发难治急性B淋巴细胞白血病(B-ALL)的有效性和安全性。方法选取2021年9月至2022年6月新乡医学院附属焦作市人民医院、焦作煤业集团中央医院、焦作市第二人民医院收治的20例接受硼替佐米联合化疗治疗的复发难治B-ALL患者,回顾性分析其治疗反应和预后。结果20例患者中位年龄49.5岁(25.0~58.5岁);男性12例,女性8例;复发12例,难治8例。所有患者均完成1个疗程硼替佐米(1.6 mg/m2,第2、16天皮下注射)联合化疗。20例患者硼替佐米治疗前完全缓解(CR)0例,部分缓解(PR)7例,未缓解(NR)13例,客观缓解率(ORR)35%(7/20),微小残留病(MRD)均阳性;治疗后CR 13例,PR 3例,NR 4例,ORR 80%(16/20),MRD均下降,其中13例(65%)转阴;硼替佐米治疗前后CR率、ORR、MRD转阴率比较,差异均有统计学意义(χ^(2)值分别为65.41、8.83、19.30,均P<0.05)。20例患者中4例虽骨髓缓解,但出现中枢神经系统浸润,1例因化疗后感染死亡。所有患者均发生骨髓抑制,感染发生率为90%(18/20),消化系统不良反应发生率为75%(15/20)。结论硼替佐米联合常规化疗方案治疗复发难治ALL有效且耐受性良好,有可能使多重耐药复发的患者克服耐药,从而达到深度缓解。
Objective To investigate the effectiveness and safety of bortezomib combined with conventional chemotherapy regimens for treatment of relapsed/refractory acute B lymphoblastic leukemia(B-ALL).Methods Twenty patients with relapsed/refractory B-ALL treated with bortezomib combined with chemotherapy in Jiaozuo People's Hospital Affiliated to Xinxiang Medical College,Jiaozuo Coal Industry Group Central Hospital and the Second People's Hospital of Jiaozuo from September 2021 to June 2022 were collected,and their treatment response and prognosis were retrospectively analyzed.Results The median age of the 20 patients was 49.5 years old(25.0-58.5 years old);12 were male and 8 were female;12 were relapsed and 8 were refractory.All patients completed 1 course of bortezomib(1.6 mg/m2,subcutaneous injection on days 2 and 16)combined with chemotherapy.Before bortezomib treatment,there were 0 case of complete remission(CR),7 cases of partial remission(PR)and 13 cases of non-remission(NR)in 20 patients,the objective remission rate(ORR)was 35%(7/20),and all were positive for minimal residual disease(MRD).After bortezomib treatment,there were 13 cases of CR,3 cases of PR and 4 cases of NR,and the ORR was 80%(16/20);the MRD of all patients decreased,among which 13 cases(65%)turned to negative;the differences were statistically significant when comparing CR rate,ORR and MRD negative conversion rate before and after bortezomib treatment(χ^(2)values were 65.41,8.83 and 19.30,all P<0.05).Four of the 20 patients developed central nervous system infiltration despite bone marrow remission,and one died from post-chemotherapy infection.Myelosuppression occurred in all patients,the incidence of infection was 90%(18/20),and the incidence of digestive system adverse effects was 75%(15/20).Conclusions Bortezomib combined with conventional chemotherapy regimens is effective and well tolerated in the treatment of relapsed/refractory ALL,and has the potential to enable patients with multi-drug resistant relapse to overcome resistance and to achieve deep remission.
作者
张如玥
宋庆林
裴智信
李仙松
江梅
Zhang Ruyue;Song Qinglin;Pei Zhixin;Li Xiansong;Jiang Mei(Graduate School,Xinxiang Medical College,Xinxiang 453003,China;Department of Hematology,Jiaozuo People's Hospital Affiliated to Xinxiang Medical College,Jiaozuo 454002,China;Department of Hematology,Jiaozuo Coal Industry Group Central Hospital,Jiaozuo 454000,China;Department of Hematology,the Second People's Hospital of Jiaozuo,Jiaozuo 454001,China)
出处
《白血病．淋巴瘤》
CAS
2023年第4期230-234,共5页
Journal of Leukemia & Lymphoma
关键词
白血病
药物疗法
联合
硼替佐米
治疗结果
Leukemia
Drug therapy,combination
Bortezomib
Treatment outcome
