Inotuzumab ozogamycyny w leczeniu chorych na ostrą białaczkę limfoblastyczną

Q4 Medicine

Hematologia Pub Date : 2019-03-04 DOI:10.5603/HEM.2018.0036

A. Gołoś, J. Góra-Tybor

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引用次数: 0

Abstract

Acute lymphoblastic leukemia (ALL) comprises about 20% of leukemias in adult. Though the high complete remission (CR) rates after the first-line chemotherapy, only 30–40% of ALL patients may be cured. The prognosis of relapsed/refractory ALL remains poor. The 5-year overall survival (OS) rate is 7–10%. In recent years, new therapies utilizing monoclonal antibodies have been investigated. Inotuzumab ozogamycin is a humanized anti-CD22 antibody conjugated to an alkylating agent — calicheamicin. The drug was registered for relapsed/refractory ALL in adults based on INO-VATE trial, a phase III trial comparing efficacy of inotuzumab ozogamycin to chemotherapy. CR rates, progression-free survival, and OS were significantly higher in the inotuzumab group. In addition, significantly more patients from the inotuzumab group were treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). The most common adverse events were neutropenia and thrombocytopenia. Among the non-hematological adverse events the veno-occlusive disease (VOD) was the most dangerous. The frequency of VOD increased in patients who underwent allo-HSCT. This article presents the most important clinical trials with inotuzumab ozogamycin and the toxicity of the drug.

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急性淋巴细胞白血病(ALL)约占成人白血病的20%。虽然一线化疗后的完全缓解率很高，但只有30-40%的ALL患者可以治愈。复发/难治性ALL的预后仍然很差。5年总生存率(OS)为7-10%。近年来，人们研究了利用单克隆抗体的新疗法。Inotuzumab ozogamycin是一种人源抗cd22抗体，偶联烷基化剂calicheamicin。基于INO-VATE试验，该药注册用于复发/难治性ALL成人患者，这是一项比较inotuzumab ozogamycin与化疗疗效的III期试验。在inotuzumab组中，CR率、无进展生存期和OS明显更高。此外，inotuzumab组接受同种异体造血干细胞移植(alloo - hsct)治疗的患者明显更多。最常见的不良事件是中性粒细胞减少症和血小板减少症。在非血液学不良事件中，静脉闭塞性疾病(VOD)是最危险的。在接受同种异体造血干细胞移植的患者中，VOD的频率增加。这篇文章介绍了inotuzumab ozogamycin最重要的临床试验和药物的毒性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hematologia Medicine-Oncology

自引率

0.00%

发文量

审稿时长

4 weeks

期刊介绍： Hematology is the quarterly under auspices of the Institute of Hematology and Transfusion Medicine. The journal is addressed to hematologists, oncologists and also internists. It contains the overview/review articles, case reports, essays, including reports from the scientific and educational conferences as well as test questions on hematology. Journal of the Institute of Hematology and Transfusiology.