JCO:阿扎胞苷单药或与来那度胺或伏立诺他联合用药治疗高风险骨髓增生异常综合征或慢性单核细胞白血病

2017-05-12 MedSci MedSci原创

阿扎胞苷是治疗高风险骨髓增生异常综合征的标准一线用药。阿扎胞苷联合来那度胺或伏立诺他治疗的总缓解率是否优于阿扎胞苷单药尚未知。

阿扎胞苷是治疗高风险骨髓增生异常综合征的标准一线用药。阿扎胞苷联合来那度胺或伏立诺他治疗的总缓解率是否优于阿扎胞苷单药尚未知。

JCO近期报道了一篇文章,研究阿扎胞苷单药及阿扎胞苷联合来那度胺或伏立诺他治疗骨髓增生异常综合征以及慢性单核细胞白血病的治疗效果。研究将患者随机分配到三个组中,阿扎胞苷组(57mg/m2/day 1-7天 28天一个周期),阿扎胞苷联合来那度胺组(10mg/day 1-21天),阿扎胞苷联合伏立诺他组(300mg 一天2次 3-9天)。研究最终纳入90个中心的277例患者,阿扎胞苷单药组92人,阿扎胞苷联合来那度胺组93人,阿扎胞苷联合伏立诺他组92人。平均年龄70岁,女性85例,慢性单核细胞白血病患者53例。组间的严重不良反应情况相似,但是联合用药组更容易出现剂量调整。平均随访时间23个月,接受阿扎胞苷单药治疗的患者总反应率为38%,阿扎胞苷联合来那度胺总反应率为49%,阿扎胞苷联合伏立诺他总反应率为27%。对于慢性单核细胞白血病的患者,阿扎胞苷联合来那度胺的总反应率高于阿扎胞苷单药组(68% vs28%),但是各细胞遗传学亚组之间总反应率相近。DNMT3A突变的总反应率较高而SRSF2突变的总反应率较低。来那度胺剂量减少与总生存情况不良有关。

文章最后认为,高风险骨髓增生异常综合征的患者接受阿扎胞苷单药或联合用药治疗的总反应率相似,慢性单核细胞白血病的患者阿扎胞苷联合来那度胺治疗效果更好。联合用药的效果可能会受到剂量调整的影响。

原始出处:

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    2019-03-23 1205b98am87(暂无昵称)

    应该是75mg/m2

    0

  2. 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createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1514276, encodeId=c45215142e68a, content=<a href='/topic/show?id=9d7c80e14b3' target=_blank style='color:#2F92EE;'>#联合用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80714, encryptionId=9d7c80e14b3, topicName=联合用药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f510649899, createdName=ms4964546379600229, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
    2017-09-29 lidong40
  4. 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createdName=heli0118, createdTime=Sun Feb 25 23:52:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862014, encodeId=98511862014ad, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Jun 28 01:52:00 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821738, encodeId=b0671821e3812, content=<a href='/topic/show?id=d1ba10196122' target=_blank style='color:#2F92EE;'>#骨髓增生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101961, encryptionId=d1ba10196122, topicName=骨髓增生)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Sun Sep 10 09:52:00 CST 2017, time=2017-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1755454, encodeId=d9a31e554542a, content=<a href='/topic/show?id=923d3621055' target=_blank style='color:#2F92EE;'>#单核细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36210, encryptionId=923d3621055, topicName=单核细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=921f36899155, createdName=pcw118, createdTime=Mon Apr 09 10:52:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299104, encodeId=f1351299104cc, content=<a href='/topic/show?id=2b85362063c' target=_blank style='color:#2F92EE;'>#单核细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36206, encryptionId=2b85362063c, topicName=单核细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430813, encodeId=622e143081347, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1514276, encodeId=c45215142e68a, content=<a href='/topic/show?id=9d7c80e14b3' target=_blank style='color:#2F92EE;'>#联合用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80714, encryptionId=9d7c80e14b3, topicName=联合用药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f510649899, createdName=ms4964546379600229, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
  5. 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createdName=heli0118, createdTime=Sun Feb 25 23:52:00 CST 2018, time=2018-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862014, encodeId=98511862014ad, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Jun 28 01:52:00 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1821738, encodeId=b0671821e3812, content=<a href='/topic/show?id=d1ba10196122' target=_blank style='color:#2F92EE;'>#骨髓增生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101961, 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content=<a href='/topic/show?id=2b85362063c' target=_blank style='color:#2F92EE;'>#单核细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36206, encryptionId=2b85362063c, topicName=单核细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430813, encodeId=622e143081347, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1514276, encodeId=c45215142e68a, content=<a href='/topic/show?id=9d7c80e14b3' target=_blank style='color:#2F92EE;'>#联合用药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80714, encryptionId=9d7c80e14b3, topicName=联合用药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f510649899, createdName=ms4964546379600229, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=)]
  6. 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encryptionId=d1ba10196122, topicName=骨髓增生)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=fengyqf, createdTime=Sun Sep 10 09:52:00 CST 2017, time=2017-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1755454, encodeId=d9a31e554542a, content=<a href='/topic/show?id=923d3621055' target=_blank style='color:#2F92EE;'>#单核细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36210, encryptionId=923d3621055, topicName=单核细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=921f36899155, createdName=pcw118, createdTime=Mon Apr 09 10:52:00 CST 2018, time=2018-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299104, encodeId=f1351299104cc, content=<a href='/topic/show?id=2b85362063c' target=_blank style='color:#2F92EE;'>#单核细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36206, encryptionId=2b85362063c, topicName=单核细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sun May 14 06:52:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430813, encodeId=622e143081347, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, 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  7. 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  8. 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  9. 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  10. 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