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Cancer Discov：Venetoclax+Navitoclax+化疗治疗复发/难治性急性淋巴细胞白血病和淋巴母细胞淋巴瘤

2021-02-18 Nebula MedSci原创

淋巴母细胞淋巴瘤navitoclaxvenetoclax复发/难治性急性淋巴细胞白血病
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复发性/难治性急性淋巴细胞白血病和前体B/T细的预后仍差强人意，新治疗方法是否可带来令人满意的疗效呢？

复发性/难治性急性淋巴细胞白血病（ALL）患者的预后仍差强人意，特别是那些接受了二次或后续挽救治疗的患者。据报道，接受二次挽救治疗的复发性/难治性ALL儿科和成年患者的完全缓解率（CR）分别低至44%和18%。难治性/复发性前体B/T细胞淋巴瘤（LL）的患者预后也是这么差。因此，在这种情况下，难治性/复发性ALL和LL都亟需新的治疗方法。

联合使用选择性BCL-2抑制剂venotclax和小剂量的navitoclax(BCL-XL/BCL-2抑制剂)，可以同时靶向BCL-2和BCL-XL，且不会出现与nacitoclax单一治疗相关的剂量限制性血小板减少。

近日发表在《Cancer Discovery》上的一篇最新研究“Venetoclax and Navitoclax in Combination with Chemotherapy in Patients with Relapsed or Refractory Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma”，是一项I期剂量递增性试验(NCT03181126)，在复发性/难治性ALL或LL的儿童和成人患者中评估了venotclax联合小剂量navitoclax和化疗的安全性和初步疗效。

结果显示，共47名患者接受了研究治疗。Venotclax用于成人患者的推荐II期剂量为50 mg，体重小于45公斤的患者的为25 mg。主要的安全性发现是造血恢复延迟。完全缓解率为60%，包括既往接受造血细胞移植或免疫治疗的患者。13例(28%)患者在研究过程中进行了移植或CAR T细胞治疗。

综上所述，venotclax联合navitoclax和化疗用于不同年龄段的治性/复发性ALL和LL患者的耐受性良好，且具有很好的疗效。

原始出处：

Pullarkat Vinod A,Lacayo Norman J,Jabbour Elias et al. Venetoclax and Navitoclax in Combination with Chemotherapy in Patients with Relapsed or Refractory Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma. Cancer Discov, 2021, 10.1158/2159-8290.CD-20-1465

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    2021-07-03 zhaojie88

    #Dis#

    0

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    2021-10-09 canlab

    #NET#

    0

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    2021-09-24 你的小可爱突然出现

    学习

    0

  4. 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href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587909, encodeId=f6cc158e909b4, content=<a href='/topic/show?id=cb1e1006ebd' target=_blank style='color:#2F92EE;'>#ISC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10067, encryptionId=cb1e1006ebd, topicName=ISC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173417575755, createdName=yankaienglish, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-03-06 marlenexl

    #细胞淋巴瘤#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2013589, encodeId=2ef3201358942, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jul 03 07:04:34 CST 2021, time=2021-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734314, encodeId=03901e3431467, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, 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level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Thu Jun 03 20:04:34 CST 2021, time=2021-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302362, encodeId=3beb1302362c9, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528733, encodeId=34cf1528e3397, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587909, encodeId=f6cc158e909b4, content=<a href='/topic/show?id=cb1e1006ebd' target=_blank style='color:#2F92EE;'>#ISC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10067, encryptionId=cb1e1006ebd, topicName=ISC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173417575755, createdName=yankaienglish, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2022-01-29 appleandpeer

    #navitoclax#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2013589, encodeId=2ef3201358942, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jul 03 07:04:34 CST 2021, time=2021-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734314, encodeId=03901e3431467, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, 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time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-06-03 sunyl07

    #淋巴细胞白血病#

    0

  7. 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href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587909, encodeId=f6cc158e909b4, content=<a href='/topic/show?id=cb1e1006ebd' target=_blank style='color:#2F92EE;'>#ISC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10067, encryptionId=cb1e1006ebd, topicName=ISC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173417575755, createdName=yankaienglish, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-02-20 wetgdt

    #淋巴细胞#

    0

  8. 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level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Thu Jun 03 20:04:34 CST 2021, time=2021-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302362, encodeId=3beb1302362c9, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528733, encodeId=34cf1528e3397, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587909, encodeId=f6cc158e909b4, content=<a href='/topic/show?id=cb1e1006ebd' target=_blank style='color:#2F92EE;'>#ISC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10067, encryptionId=cb1e1006ebd, topicName=ISC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173417575755, createdName=yankaienglish, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-02-20 freve

    #难治性#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2013589, encodeId=2ef3201358942, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jul 03 07:04:34 CST 2021, time=2021-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734314, encodeId=03901e3431467, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, 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attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=201630414353, createdName=marlenexl, createdTime=Sat Mar 06 00:04:34 CST 2021, time=2021-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1746653, encodeId=bbca1e466531f, content=<a href='/topic/show?id=4ec812553cb' target=_blank style='color:#2F92EE;'>#navitoclax#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12553, encryptionId=4ec812553cb, topicName=navitoclax)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3aec35811804, createdName=appleandpeer, createdTime=Sat Jan 29 18:04:34 CST 2022, time=2022-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998006, encodeId=26fe199800654, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Thu Jun 03 20:04:34 CST 2021, time=2021-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302362, encodeId=3beb1302362c9, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528733, encodeId=34cf1528e3397, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587909, encodeId=f6cc158e909b4, content=<a href='/topic/show?id=cb1e1006ebd' target=_blank style='color:#2F92EE;'>#ISC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10067, encryptionId=cb1e1006ebd, topicName=ISC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=173417575755, createdName=yankaienglish, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-02-20 yankaienglish

    #ISC#

    0

  10. 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level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Thu Jun 03 20:04:34 CST 2021, time=2021-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302362, encodeId=3beb1302362c9, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sat Feb 20 14:04:34 CST 2021, time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528733, encodeId=34cf1528e3397, content=<a 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time=2021-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=925362, encodeId=530d925362a1, content=继续来学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200627/83a502bff6c14b759a7d0863b4068e7b/32ad40676056418ea58a94afac9c5b81.jpg, createdBy=6f475314305, createdName=水-晶, createdTime=Thu Feb 18 23:22:18 CST 2021, time=2021-02-18, status=1, ipAttribution=)]
    2021-02-18 水-晶

    继续来学习了

    0

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　　哈尔滨医科大学附属第三医院 田浴阳 郭秀臣 李福德 刘爱春 　　目的：淋巴母细胞淋巴瘤(LBL)是高度侵袭性淋巴瘤，好发于儿童和青少年，早期易侵犯骨髓和中枢，用CHOP或CHOP样方案治疗，治愈率不足30%。BFM-90方案是治疗儿童急淋白血病的最佳方案，近年，国际和国内的少数医疗单位报道用BFM-90方案治疗青少年LBL获得较好疗效。因青少年和成人的