Blood:JAK2抑制剂用于治疗骨髓增生性肿瘤(MFN)的效果和安全性评估

2018-04-13 MedSci MedSci原创

骨髓增生性肿瘤(MPNs)包括原发性血小板增多症、红细胞增多症(PV)和原发性骨髓纤维化(PMF)。在MPNs中可观察到JAK2。CALR和MPL基因发生表型驱动性突变,并可与额外的突变结合产生多样的表型。JAK2/STAT信号通路是MPNs的关键信号级联反应,驱动性突变可导致其构成性激活。卢索替尼(RUX),JAK2抑制剂(JAKis)的一种,已被批准用于治疗中高危的骨髓纤维化(MF)和羟基脲不

骨髓增生性肿瘤(MPNs)包括原发性血小板增多症、红细胞增多症(PV)和原发性骨髓纤维化(PMF)。在MPNs中可观察到JAK2。CALR和MPL基因发生表型驱动性突变,并可与额外的突变结合产生多样的表型。JAK2/STAT信号通路是MPNs的关键信号级联反应,驱动性突变可导致其构成性激活。

卢索替尼(RUX),JAK2抑制剂(JAKis)的一种,已被批准用于治疗中高危的骨髓纤维化(MF)和羟基脲不能控制或不耐受的红细胞增多症。而其他JAKis,如fedratinib和pacritinib,被批准用于治疗MF。MF试验的主要结点是脾体积缓解(SVR)和症状缓解,而在PV试验中,主要结点是红细胞压积(有/无脾缓解)的管理

对于晚期MF患者,RUX治疗在60%的患者中超过35%的患者获得SVR,并且持续较长时间,为MF治疗提供新的基准。RUX在早期MF中的疗效也相对显著,而且毒性轻微。对于PV患者,约60%的病例和40%的SVR病例实现红细胞压积的管理。在两种情况下,症状缓解均很明显。但随时间的延长,很多MF患者丧失脾体积缓解。血红蛋白/血小板比值降低和感染率增加,是RUX最常见的副反应,而非黑色素瘤皮肤肿瘤需要在治疗期间进行检测。

总而言之,引入JAKis可提高MF和PV的治疗预后期望。

原始出处:

Francesco Passamonti and Margherita Maffioli.The role of JAK2 inhibitors in MPN seven years after approval.Blood  2018  :blood-2018-01-791491;  doi: https://doi.org/10.1182/blood-2018-01-791491

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  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Apr 17 12:27:07 CST 2018, time=2018-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1351313, encodeId=380c13513134b, content=<a href='/topic/show?id=435e10196e86' target=_blank style='color:#2F92EE;'>#骨髓增生性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101967, encryptionId=435e10196e86, topicName=骨髓增生性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 15 12:11:00 CST 2018, time=2018-04-15, status=1, ipAttribution=), 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createdName=1e145228m78(暂无匿称), createdTime=Sat Apr 14 08:49:54 CST 2018, time=2018-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305556, encodeId=806530555663, content=骨髓增生性肿瘤(MPNs)包括原发性血小板增多症.红细胞增多症(PV)和原发性骨髓纤维化(PMF).在MPNs中可观察到JAK2.CALR和MPL基因发生表型驱动性突变.并可与额外的突变结合产生多样的表型.JAK2/STAT信号通路是MPNs的关键信号级联反应.驱动性突变可导致其构成性激活., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Apr 14 05:01:53 CST 2018, time=2018-04-14, status=1, ipAttribution=)]
    2018-07-21 jklm09
  6. 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createdName=1e145228m78(暂无匿称), createdTime=Sat Apr 14 08:49:54 CST 2018, time=2018-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305556, encodeId=806530555663, content=骨髓增生性肿瘤(MPNs)包括原发性血小板增多症.红细胞增多症(PV)和原发性骨髓纤维化(PMF).在MPNs中可观察到JAK2.CALR和MPL基因发生表型驱动性突变.并可与额外的突变结合产生多样的表型.JAK2/STAT信号通路是MPNs的关键信号级联反应.驱动性突变可导致其构成性激活., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Apr 14 05:01:53 CST 2018, time=2018-04-14, status=1, ipAttribution=)]
    2018-04-17 天地飞扬

    了解一下.谢谢分享!

    0

  7. 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    2018-04-15 gao_jian4220
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createdName=1e145228m78(暂无匿称), createdTime=Sat Apr 14 08:49:54 CST 2018, time=2018-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305556, encodeId=806530555663, content=骨髓增生性肿瘤(MPNs)包括原发性血小板增多症.红细胞增多症(PV)和原发性骨髓纤维化(PMF).在MPNs中可观察到JAK2.CALR和MPL基因发生表型驱动性突变.并可与额外的突变结合产生多样的表型.JAK2/STAT信号通路是MPNs的关键信号级联反应.驱动性突变可导致其构成性激活., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Apr 14 05:01:53 CST 2018, time=2018-04-14, status=1, ipAttribution=)]
    2018-04-14 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

  10. 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    2018-04-14 有备才能无患

    骨髓增生性肿瘤(MPNs)包括原发性血小板增多症.红细胞增多症(PV)和原发性骨髓纤维化(PMF).在MPNs中可观察到JAK2.CALR和MPL基因发生表型驱动性突变.并可与额外的突变结合产生多样的表型.JAK2/STAT信号通路是MPNs的关键信号级联反应.驱动性突变可导致其构成性激活.

    0

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