摘要
目的观察达雷妥尤单抗(Dara)治疗复发/难治性急性白血病(R/R-AL)的效果。方法回顾性分析2019年1月至2021年6月在郑州大学第一附属医院接受Dara治疗的7例R/R-AL患者的临床资料。结果治疗前,7例患者均存在CD38表达,中位表达量为91%(50%~100%)。所有患者接受Dara治疗中位次数为4(1~6)次。5例(71.4%)患者采用Dara联合化疗,1例(14.3%)采用Dara联合全反式维甲酸,1例(14.3%)采用Dara单药治疗。治疗后1例(14.3%)患者获得完全缓解(CR),3例(42.9%)患者获得部分缓解(PR),总有效率为57.2%。其中1例难治急性髓系白血病(AML)患者经2个剂量Dara联合化疗后CR,现已无病生存11个月,1例复发急性淋巴细胞白血病患者经2个剂量Dara联合化疗后骨髓微小残留病下降90.2%,2例髓外浸润患者经Dara治疗后复查CT示淋巴结及软组织肿块明显缩小,评估为PR。结论Dara可成功诱导难治AML完全缓解并维持较长的无病生存期,同时可能对髓外病变产生抗肿瘤作用。
Objective To observe the efficacy of daratumumab(Dara)in the treatment of relapsed/refractory acute leukemia(R/R-AL).Methods The clinical data of 7 patients with R/R-AL treated by Dara in the First Affiliated Hospital of Zhengzhou University from January 2019 to June 2021 were analyzed retrospectively.Results Before treatment,the expression of CD38 was positive in all 7 patients,and the median expression was about 91%(50%-100%).All patients received a median of 4(1-6)doses of Dara.A total of 5(71.4%)cases were treated with Dara combined with chemotherapy,1(14.3%)case with Dara combined with all-trans retinoic acid,and 1(14.3%)case with Dara monotherapy.After treatment,1(14.3%)patient achieved complete remission(CR)and 3(42.9%)patients achieved partial remission(PR),with an overall response rate of 57.2%.Among them,1 patient with refractory acute myeloid leukemia(AML)underwent CR after 2 doses of Dara combined with chemotherapy,and now has a disease-free survival of 11 months,and 1 patient with relapsed acute lymphoblastic leukemia received 2 doses of Dara combined with chemotherapy,the bone marrow minimal residual disease decreased by 90.2%,and 2 patients with extramedullary lesions showed that the lymph nodes and soft tissue were reduced by CT scan,which were evaluated as PR.Conclusion Dara can successfully induce complete remission of refractory AML and maintain a long disease-free survival.At the same time,it may have anti-tumor effect on extramedullary lesions.
作者
赵海秋
卢润青
谢新生
万鼎铭
姜中兴
何飞
刘珍珍
樊冀鑫
郭荣
ZHAO Haiqiu;LU Runqing;XIE Xinsheng;WAN Dingming;JIANG Zhongxing;HE Fei;LIU Zhenzhen;FAN Jixin;GUO Rong(Department of Hematology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2022年第11期1926-1930,共5页
Henan Medical Research
基金
国家自然科学基金(81070445)
河南省自然科学基金(182300410301)
河南省医学科技攻关计划(201403029)
河南省医学科技攻关计划省部共建备选项目(2018010001)。
