J Hematol Oncol:延缓晚期骨髓纤维变性患者骨髓纤维化进展 鲁索利替尼大放异彩

2018-12-12 王淳 环球医学

2018年3月,德国和美国学者发表在《J Hematol Oncol》的一项研究,考察了鲁索利替尼vs最佳现有治疗对骨髓纤维变性(MF)患者骨髓纤维化的长期影响。

2018年3月,德国和美国学者发表在《J Hematol Oncol》的一项研究,考察了鲁索利替尼vs最佳现有治疗对骨髓纤维变性(MF)患者骨髓纤维化的长期影响。

背景:骨髓纤维变性是一种可缩短寿命的骨髓增生性肿瘤的并发症,与无效的造血、脾肿大、进展性骨髓(BM)纤维化相关。与安慰剂或最佳现有治疗(BAT)相比,口服JAK激酶1/2抑制剂鲁索利替尼已经表现出可改善中等-2或高风险骨髓纤维变性患者脾肿大,减轻症状负担,增加总生存期。

方法:研究者对68名具有不同骨髓纤维化级别的晚期骨髓纤维变性患者和192名配对的接受BAT治疗的患者,进行了鲁索利替尼治疗66个月对骨髓形态学影响的比较。独立进行了环钻活组织检查,并由3名血液病理学家进行盲审,对网状纤维化级别、胶原沉积和骨硬化症进行基于共识的判断。

结果:基于网状纤维化级别自基线的改变,与BAT相比,鲁索利替尼与较高的骨髓纤维化改善或稳定的几率,以及骨髓纤维化恶化几率降低相关。一般来说,这些改变伴随着持续高水平的个体脾脏缩小和白成红细胞增多症的衰退。更晚期基线纤维化患者显示出脾脏大小应答降低。

结论:结果表明,长期鲁索利替尼治疗可能逆转或显着延缓晚期骨髓纤维变性患者的骨髓纤维化进展,这表明,持续JAK抑制可能对疾病进程产生影响。

原始出处:

Kvasnicka HM, Thiele J, Bueso-Ramos CE, et al. Long-term effects of ruxolitinib versus best available therapy on bone marrow fibrosis in patients with myelofibrosis. J Hematol Oncol. 2018 Mar 15;11(1):42. doi: 10.1186/s13045-018-0585-5.

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    2019-10-14 minlingfeng
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    2018-12-14 fengyi812
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    2018-12-14 huangdf