Chinese General Practice ›› 2022, Vol. 25 ›› Issue (08): 957-962.DOI: 10.12114/j.issn.1007-9572.2022.02.005
• Original Research • Previous Articles Next Articles
Clinical Study of Venetoclax with Chemotherapy for Relapsed/Refractory Acute Myeloid Leukemia
Department of Hematology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233003,China
*Corresponding author:LI Jiajia,Associate chief physician;E-mail:4119469 @ qq.com
Received:
2021-09-25
Revised:
2022-01-05
Published:
2022-03-15
Online:
2022-03-02
通讯作者:
李佳佳
基金资助:
CLC Number:
CHEN Xiaofeng, WANG Meng, LI Zhongyu, LI Jiajia.
Clinical Study of Venetoclax with Chemotherapy for Relapsed/Refractory Acute Myeloid Leukemia [J]. Chinese General Practice, 2022, 25(08): 957-962.
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.02.005
病例 | 年龄(岁) | 性别 | 诊断 | 染色体 | 基因突变 | 预后 |
---|---|---|---|---|---|---|
1 | 43 | 男 | M5,复发难治性 | 46,XY | NPM1、DNMT3a | 良好 |
2 | 33 | 男 | M5,复发难治性 | 46,XY | SRDFR、FLT3-ITD | 不良 |
3 | 51 | 男 | M2,复发难治性 | 46,XY | WT1 | 中等 |
4 | 67 | 男 | M2,复发难治性 | 复杂核型a | (-) | 不良 |
5 | 43 | 女 | M2,复发难治性 | 46,XX,t(8;21)(q22;q22) | WT1 | 良好 |
6 | 51 | 男 | M2,复发难治性 | 46,XY | NRAS、ASXL1、RUNX1 | 不良 |
7 | 64 | 女 | M5,复发 | 46,XX | (-) | 中等 |
8 | 54 | 女 | M5,复发 | 复杂核型b | IDH2、WT1 | 不良 |
9 | 42 | 男 | M5,复发难治性 | 46,XY,t(8;21)(q22;q22) | NRAS、NF1、WT1 | 良好 |
10 | 31 | 男 | M5,复发难治性 | 46,XY | DEK-CAN、FLT3-ITD | 不良 |
Table 1 General clinical characteristics of 10 adult cases of relapsed/refractory acute myeloid leukemia
病例 | 年龄(岁) | 性别 | 诊断 | 染色体 | 基因突变 | 预后 |
---|---|---|---|---|---|---|
1 | 43 | 男 | M5,复发难治性 | 46,XY | NPM1、DNMT3a | 良好 |
2 | 33 | 男 | M5,复发难治性 | 46,XY | SRDFR、FLT3-ITD | 不良 |
3 | 51 | 男 | M2,复发难治性 | 46,XY | WT1 | 中等 |
4 | 67 | 男 | M2,复发难治性 | 复杂核型a | (-) | 不良 |
5 | 43 | 女 | M2,复发难治性 | 46,XX,t(8;21)(q22;q22) | WT1 | 良好 |
6 | 51 | 男 | M2,复发难治性 | 46,XY | NRAS、ASXL1、RUNX1 | 不良 |
7 | 64 | 女 | M5,复发 | 46,XX | (-) | 中等 |
8 | 54 | 女 | M5,复发 | 复杂核型b | IDH2、WT1 | 不良 |
9 | 42 | 男 | M5,复发难治性 | 46,XY,t(8;21)(q22;q22) | NRAS、NF1、WT1 | 良好 |
10 | 31 | 男 | M5,复发难治性 | 46,XY | DEK-CAN、FLT3-ITD | 不良 |
病例 | WBC(×109/L) | Hb(g/L) | PLT(×109/L) | Blasts(%) | ||||
---|---|---|---|---|---|---|---|---|
化疗前 | 化疗后 | 化疗前 | 化疗后 | 化疗前 | 化疗后 | 化疗前 | 化疗后 | |
1 | 39.80 | 4.60 | 67.0 | 130.0 | 528.00 | 118.00 | 70.00 | 2.00 |
2 | 1.06 | 3.28 | 83.0 | 110.0 | 54.00 | 84.00 | 67.00 | 1.00 |
3 | 5.00 | 2.98 | 92.0 | 102.0 | 28.00 | 79.00 | 73.00 | 4.00 |
4 | 20.55 | 12.56 | 61.0 | 42.0 | 39.00 | 17.00 | 81.00 | 44.00 |
5 | 3.20 | 4.00 | 113.0 | 122.0 | 28.00 | 74.00 | 70.00 | 1.00 |
6 | 1.39 | 2.42 | 57.0 | 86.0 | 20.00 | 12.00 | 60.00 | 16.00 |
7 | 5.39 | 3.27 | 120.0 | 111.0 | 211.00 | 194.00 | 40.00 | 7.00 |
8 | 1.26 | 0.97 | 100.0 | 104.0 | 150.00 | 77.00 | 41.00 | 33.00 |
9 | 1.04 | 2.47 | 53.0 | 98.0 | 78.00 | 150.00 | 21.00 | 0 |
10 | 54.77 | 4.64 | 94.0 | 112.0 | 79.00 | 64.00 | 52.00 | 7.00 |
Table 2 Cytological examination of peripheral white blood cell count,hemoglobin content,and platelet count,and bone marrow of 10 patients with refractory /relapsed acute myeloid leukemia before and after chemotherapy
病例 | WBC(×109/L) | Hb(g/L) | PLT(×109/L) | Blasts(%) | ||||
---|---|---|---|---|---|---|---|---|
化疗前 | 化疗后 | 化疗前 | 化疗后 | 化疗前 | 化疗后 | 化疗前 | 化疗后 | |
1 | 39.80 | 4.60 | 67.0 | 130.0 | 528.00 | 118.00 | 70.00 | 2.00 |
2 | 1.06 | 3.28 | 83.0 | 110.0 | 54.00 | 84.00 | 67.00 | 1.00 |
3 | 5.00 | 2.98 | 92.0 | 102.0 | 28.00 | 79.00 | 73.00 | 4.00 |
4 | 20.55 | 12.56 | 61.0 | 42.0 | 39.00 | 17.00 | 81.00 | 44.00 |
5 | 3.20 | 4.00 | 113.0 | 122.0 | 28.00 | 74.00 | 70.00 | 1.00 |
6 | 1.39 | 2.42 | 57.0 | 86.0 | 20.00 | 12.00 | 60.00 | 16.00 |
7 | 5.39 | 3.27 | 120.0 | 111.0 | 211.00 | 194.00 | 40.00 | 7.00 |
8 | 1.26 | 0.97 | 100.0 | 104.0 | 150.00 | 77.00 | 41.00 | 33.00 |
9 | 1.04 | 2.47 | 53.0 | 98.0 | 78.00 | 150.00 | 21.00 | 0 |
10 | 54.77 | 4.64 | 94.0 | 112.0 | 79.00 | 64.00 | 52.00 | 7.00 |
病例 | 化疗方案 | 疗效 | CR/PR持续时间(月) | 复发次数 | OS(月) |
---|---|---|---|---|---|
1 | IA×2、HD-Ara-C×4、DA/VEN+Aza+HAAG×4 | CR/CR | 10/7 | 4/0 | 10 |
2 | IA×4、Decitabine +CAG/VEN+Aza+HAAG×3 | CR/CR | 5/5 | 2/0 | 6 |
3 | HD-Ara-C×2、IA、Decitabine+HAG×2、Chidamide +CLAG /VEN+Aza+HAAG×2 | CR/CR | 12/3 | 3/0 | 3 |
4 | IA、Decitabine +HAG×2/VEN+Aza+HAAG | CR/NR | 2/- | 2/- | 1 |
5 | IA×3、MD-Ara-C、FLAG×2、HA、Decitabine+Chidamide+CLAG/VEN+Aza+HAAG×4 | CR/CR | 11/7 | 2/0 | 9 |
6 | HD-Ara-C、IA×2、Decitabine +CAG×2/VEN+Aza+HAAG×2 | PR/PR | 3/1 | 3/1 | 3 |
7 | Decitabine+CAG、Decitabine+HAAG/ VEN+Aza+HAAG×2 | CR/PR | 7/6 | 1/0 | 7 |
8 | IA×2、HD-Ara-C×2、Decitabine +HAG/ VEN+Aza+HAAG×2 | CR/NR | 2/- | 2/- | 2 |
9 | Decitabine +HAG、IA/ VEN+Aza+HAAG×5 | PR/CR | 1/10 | 1/0 | 13 |
10 | IA、Decitabine +HAAG/VEN+Aza+HAAG×4 | NR/CR | 2/4 | 2/1 | 7 |
Table 3 Chemotherapy regimens and survival of 10 patients with relapsed/refractory acute myeloid leukemia
病例 | 化疗方案 | 疗效 | CR/PR持续时间(月) | 复发次数 | OS(月) |
---|---|---|---|---|---|
1 | IA×2、HD-Ara-C×4、DA/VEN+Aza+HAAG×4 | CR/CR | 10/7 | 4/0 | 10 |
2 | IA×4、Decitabine +CAG/VEN+Aza+HAAG×3 | CR/CR | 5/5 | 2/0 | 6 |
3 | HD-Ara-C×2、IA、Decitabine+HAG×2、Chidamide +CLAG /VEN+Aza+HAAG×2 | CR/CR | 12/3 | 3/0 | 3 |
4 | IA、Decitabine +HAG×2/VEN+Aza+HAAG | CR/NR | 2/- | 2/- | 1 |
5 | IA×3、MD-Ara-C、FLAG×2、HA、Decitabine+Chidamide+CLAG/VEN+Aza+HAAG×4 | CR/CR | 11/7 | 2/0 | 9 |
6 | HD-Ara-C、IA×2、Decitabine +CAG×2/VEN+Aza+HAAG×2 | PR/PR | 3/1 | 3/1 | 3 |
7 | Decitabine+CAG、Decitabine+HAAG/ VEN+Aza+HAAG×2 | CR/PR | 7/6 | 1/0 | 7 |
8 | IA×2、HD-Ara-C×2、Decitabine +HAG/ VEN+Aza+HAAG×2 | CR/NR | 2/- | 2/- | 2 |
9 | Decitabine +HAG、IA/ VEN+Aza+HAAG×5 | PR/CR | 1/10 | 1/0 | 13 |
10 | IA、Decitabine +HAAG/VEN+Aza+HAAG×4 | NR/CR | 2/4 | 2/1 | 7 |
病例 | 骨髓抑制(级) | 脱发(级) | 感染(级) | 出血(级) | 恶心(级) | 腹泻(级) | 肝功能异常(级) |
---|---|---|---|---|---|---|---|
1 | 3 | 1 | 1 | 0 | 1 | 1 | 0 |
2 | 3 | 1 | 1 | 2 | 1 | 1 | 0 |
3 | 4 | 1 | 2 | 1 | 2 | 0 | 1 |
4 | 3 | 1 | 4 | 2 | 2 | 2 | 1 |
5 | 4 | 2 | 2 | 2 | 2 | 1 | 0 |
6 | 4 | 1 | 2 | 2 | 1 | 0 | 0 |
7 | 4 | 1 | 2 | 1 | 1 | 1 | 0 |
8 | 4 | 2 | 2 | 4 | 2 | 1 | 0 |
9 | 3 | 0 | 1 | 0 | 1 | 1 | 0 |
10 | 4 | 1 | 1 | 2 | 1 | 0 | 0 |
Table 4 Toxic and side effects during chemotherapy in 10 patients with relapsed/refractory acute myeloid leukemia
病例 | 骨髓抑制(级) | 脱发(级) | 感染(级) | 出血(级) | 恶心(级) | 腹泻(级) | 肝功能异常(级) |
---|---|---|---|---|---|---|---|
1 | 3 | 1 | 1 | 0 | 1 | 1 | 0 |
2 | 3 | 1 | 1 | 2 | 1 | 1 | 0 |
3 | 4 | 1 | 2 | 1 | 2 | 0 | 1 |
4 | 3 | 1 | 4 | 2 | 2 | 2 | 1 |
5 | 4 | 2 | 2 | 2 | 2 | 1 | 0 |
6 | 4 | 1 | 2 | 2 | 1 | 0 | 0 |
7 | 4 | 1 | 2 | 1 | 1 | 1 | 0 |
8 | 4 | 2 | 2 | 4 | 2 | 1 | 0 |
9 | 3 | 0 | 1 | 0 | 1 | 1 | 0 |
10 | 4 | 1 | 1 | 2 | 1 | 0 | 0 |
编号 | WBC | N | Hb | PLT |
---|---|---|---|---|
1 | 21.00 | 21.00 | 36.00 | 35.00 |
2 | 16.00 | 22.00 | 14.00 | 20.00 |
3 | 20.00 | 31.00 | 20.00 | 22.00 |
4 | 28.00 | - | - | - |
5 | 24.00 | 28.00 | 25.00 | 28.00 |
6 | 19.00 | 19.00 | 22.00 | 19.00 |
7 | 22.00 | 34.00 | - | 36.00 |
8 | 21.00 | 25.00 | 17.00 | - |
9 | 18.00 | 15.00 | 17.00 | 22.00 |
10 | 22.00 | 27.00 | 15.00 | 17.00 |
Table 5 Peripheral blood recovery time after chemotherapy in 10 patients with relapsed/refractory acute myeloid leukemia
编号 | WBC | N | Hb | PLT |
---|---|---|---|---|
1 | 21.00 | 21.00 | 36.00 | 35.00 |
2 | 16.00 | 22.00 | 14.00 | 20.00 |
3 | 20.00 | 31.00 | 20.00 | 22.00 |
4 | 28.00 | - | - | - |
5 | 24.00 | 28.00 | 25.00 | 28.00 |
6 | 19.00 | 19.00 | 22.00 | 19.00 |
7 | 22.00 | 34.00 | - | 36.00 |
8 | 21.00 | 25.00 | 17.00 | - |
9 | 18.00 | 15.00 | 17.00 | 22.00 |
10 | 22.00 | 27.00 | 15.00 | 17.00 |
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