Venetoclax 联合儿科启发方案治疗新诊断的费城染色体阴性成人急性淋巴细胞白血病。

IF 8.2 1区 医学 Q1 HEMATOLOGY
Ibrahim Aldoss, Jianying Zhang, Kathryn Shimamoto, Caner Saygin, Marjorie Robbins, Vaibhav Agrawal, Ahmed Aribi, Diren Arda Karaoglu, Hoda Pourhassan, Paul Koller, Haris Ali, Amanda Blackmon, Salman Otoukesh, Karamjeet Sandhu, Brian Ball, Andrew S Artz, Monzr M Al Malki, Amandeep Salhotra, Jose Tinajero, Zhaohui Gu, Ian Lagman, Michelle Velasquez, Jacqueline Dang, Pamela S Becker, Michelle Afkhami, Lucy Ghoda, Wendy Stock, Stephen J Forman, Anthony Stein, Guido Marcucci, Vinod Pullarkat
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引用次数: 0

摘要

BCL-2蛋白过表达常见于B细胞急性淋巴细胞白血病(B-ALL),包括费城(Ph)样亚型,它介导白血病细胞的存活。我们在诱导和巩固治疗周期中使用 BCL-2 抑制剂 Venetoclax,每天 400 毫克(剂量水平 1),并结合 CALGB 10403 方案,对 24 名新确诊的 Ph 阴性成人 B-ALL 患者进行了为期 14 天的治疗。中位年龄为31岁(18-53岁),92%为西班牙裔,12名(50%)患者为Ph-like ALL。1期研究中未出现剂量限制性毒性。中性粒细胞和血小板计数恢复的中位时间分别为诱导开始后的20天和21天。最常见的≥3级治疗相关不良事件是白细胞减少症(96%)、中性粒细胞减少症(83%)、贫血(83%)、血小板减少症(79%)、淋巴细胞减少症(71%)、高胆红素血症(38%)和谷丙转氨酶升高(33%)。23名患者(96%)在接受或不接受延长诱导期诱导后获得了完全缓解(CR)或CR伴不完全计数恢复(CRi)。在开始巩固治疗的22名患者中,20人(91%)的最小残留病灶状态(MRD-)为阴性(......)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Venetoclax in combination with a pediatric-inspired regimen for the treatment of newly diagnosed adults with Philadelphia chromosome-negative acute lymphoblastic leukemia.

BCL-2 protein overexpression, common in B-cell acute lymphoblastic leukemia (B-ALL), including the Philadelphia (Ph)-like subtype, mediates leukemic cell survival. We treated 24 patients with 14 days of BCL-2 inhibitor, venetoclax, 400 mg daily (dose level 1) during induction and consolidation cycles combined with the CALGB 10403 regimen in newly diagnosed adults with Ph-negative B-ALL. Median age was 31 (range: 18-53) years, 92% were Hispanic, and 12 (50%) patients had Ph-like ALL. No dose limiting toxicity occurred in the phase 1 part. Median times to neutrophil and platelet count recovery were 20 and 21 days from start of induction, respectively. The most common grade ≥3 treatment-related adverse events were leukopenia (96%), neutropenia (83%), anemia (83%), thrombocytopenia (79%), lymphopenia (71%), hyperbilirubinemia (38%), and elevated ALT (33%). One patient with non-Ph-like ALL died from asparaginase-associated pancreatitis, and 23 (96%) patients achieved complete remission (CR) or CR with incomplete count recovery (CRi) following induction with or without extended induction phase. Of 22 patients who started consolidation, 20 (91%) achieved negative minimal residual disease status (MRD-) (.

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来源期刊
Haematologica
Haematologica 医学-血液学
CiteScore
14.10
自引率
2.00%
发文量
349
审稿时长
3-6 weeks
期刊介绍: Haematologica is a journal that publishes articles within the broad field of hematology. It reports on novel findings in basic, clinical, and translational research. Scope: The scope of the journal includes reporting novel research results that: Have a significant impact on understanding normal hematology or the development of hematological diseases. Are likely to bring important changes to the diagnosis or treatment of hematological diseases.
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