高风险急性早幼粒细胞白血病的高度治愈性治疗:ATRA+ATO+蒽环类药物的诱导和巩固治疗以及ATRA+RIF的维持治疗。

IF 3.9 Q2 ONCOLOGY
Blood and Lymphatic Cancer-Targets and Therapy Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI:10.2147/BLCTT.S473984
Dan Liu, Juan Tong, Erling Chen, Li Wang, Lei Xue, Xuhan Zhang, Na Zhao, Xing Hu, Changcheng Zheng
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引用次数: 0

摘要

研究背景该研究旨在评估全反式维甲酸(ATRA)+三氧化二砷(ATO)+蒽环类药物诱导和巩固治疗以及ATRA+天然瑞格-靛蓝配方(RIF)维持治疗高危APL的有效性和安全性:对2012年至2021年期间接受ATRA+ATO+蒽环类药物诱导和巩固治疗以及ATRA+RIF维持治疗的21例高风险APL患者进行了分析。终点包括形态学完全缓解(CR)和分子完全缓解(CMR)、早期死亡(ED)和复发、生存率和不良事件(AEs):诱导治疗后,21名患者(100%)均获得了形态学CR,14人(66.7%)获得了CMR。21例患者中有5例在诱导治疗后未接受免疫学最小残留病(MRD)检查;但其余16例患者中有14例(87.5%)MRD阴性。获得 CR 和 CMR 的中位时间分别为 26 天(范围:16-44)和 40 天(范围:22-75)。45天内达到CR和CMR的累积概率分别为100%和76.2%(95% CI:56.9-91.3%)。所有患者均在三个疗程的巩固治疗后获得了CMR和MRD阴性。中位随访时间为66个月(25-142),至今无中枢神经系统复发和骨髓形态学或分子学复发,所有患者总生存率100%,无事件生存率100%。在诱导治疗期间,3名患者(14.3%)出现了4级不良事件(AEs),包括心律失常(1例)、肺部感染(1例)和呼吸衰竭(1例);在诱导治疗和巩固治疗期间,最常见的3级不良事件是肺部感染,分别占62.0%和28.6%,其次是中性粒细胞减少,分别占42.9%和38.1%:对于新诊断的高危APL患者,ATRA+ATO+蒽环类药物诱导和巩固治疗以及ATRA+RIF维持治疗是一种高度治愈性的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Highly Curative Treatment of High-Risk Acute Promyelocytic Leukemia: Induction and Consolidation with ATRA+ATO+anthracyclines and Maintenance with ATRA+RIF.

Background: The aim of the study was to evaluate the efficacy and safety of induction and consolidation with all-trans retinoic acid (ATRA) +arsenic trioxide (ATO) +anthracyclines and maintenance with ATRA +Realgar-Indigo naturalis formula (RIF) for high-risk APL.

Methods: Twenty-one patients with high-risk APL treated with ATRA+ATO+ anthracyclines for induction and consolidation and ATRA+RIF for maintenance from 2012 to 2021 were analyzed. Endpoints include morphological complete remission (CR) and complete molecular remission (CMR), early death (ED) and relapse, survival and adverse events (AEs).

Results: After induction treatment, all 21 patients (100%) achieved morphological CR and 14 people (66.7%) achieved CMR. Five of the 21 patients did not undergo immunological minimal residual disease (MRD) examination after induction; however, 14 of the remaining 16 patients were MRD negative (87.5%). The median time to achieve CR and CMR was 26 days (range: 16-44) and 40 days (range: 22-75), respectively. The cumulative probability of achieving CR and CMR in 45 days was 100% and 76.2% (95% CI: 56.9-91.3%), respectively. All patients achieved CMR and MRD negativity after the three courses of consolidation treatment. The median follow-up was 66 months (25-142), with no central nervous system relapse and bone marrow morphological or molecular relapse until now, and all patients survived with 100% overall survival and 100% event-free survival. Grade 4 adverse events (AEs) were observed in 3 patients (14.3%) during the induction period including arrhythmia (n = 1), pulmonary infection (n = 1) and respiratory failure (n = 1); and the most frequent grade 3 AEs were pulmonary infection, accounting for 62.0% and 28.6%, respectively, during induction and consolidation treatment, followed by neutropenia, accounting for 42.9% and 38.1%, respectively.

Conclusion: For newly diagnosed high-risk APL patients, induction and consolidation with ATRA+ATO+anthracyclines and maintenance with ATRA+RIF is a highly curative treatment approach.

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来源期刊
自引率
7.10%
发文量
16
审稿时长
16 weeks
期刊介绍: Blood and Lymphatic Cancer: Targets and Therapy is an international, peer reviewed, open access journal focusing on blood and lymphatic cancer research, identification of therapeutic targets, and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for the cancer patient. Specific topics covered in the journal include: Epidemiology, detection and screening Cellular research and biomarkers Identification of biotargets and agents with novel mechanisms of action Optimal clinical use of existing anticancer agents, including combination therapies Radiation, surgery, bone marrow transplantation Palliative care Patient adherence, quality of life, satisfaction Health economic evaluations.
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