>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
硼替佐米联合化疗治疗4例复发难治性急性淋巴细胞白血病
作者:陶善东1  宋立孝1  陈月1  丁邦和1  周立涛1  何正梅1  王春玲1  李玉峰1  于亮1 2 
单位:1. 南京医科大学附属淮安第一医院 血液科, 江苏 淮安 223300;
2. 南京医科大学 血液病重点实验室, 江苏 南京 210029
关键词:硼替佐米 联合化疗 复发难治性急性淋巴细胞白血病 
分类号:R733.71;R453
出版年·卷·期(页码):2018·37·第二期(215-219)
摘要:

目的:观察硼替佐米联合化疗方案治疗复发难治性急性淋巴细胞白血病(ALL)的疗效。方法:采用硼替佐米联合DOLP (硼替佐米1.3 mg·m-2第1、4、8、11天,柔红霉素60 mg·m-2第1至第3天,长春新碱2 mg第1、8、15、22天,门冬酰胺酶2 000 IU·m-2第2、8、15、21天,地塞米松10 mg第1至第14天)方案治疗复发难治性ALL 3例,硼替佐米联合COMEP (环磷酰胺750 mg·m-2第1、3天,米托蒽醌4 mg第1至第4天,地塞米松10 mg第1至第14天,依托泊苷0.1 g第1至4天,长春新碱2 mg第1、8、15、22天)方案治疗复发难治性ALL 1例,并通过比较化疗前后的患者血常规、骨髓细胞形态、免疫分型、细胞遗传学及NFκB表达与活性评估疗效。结果:3例硼替佐米联合DOLP方案化疗的患者中2例1个疗程完全缓解,1例1个疗程部分缓解,1例硼替佐米联合COMEP方案化疗的患者未缓解。结论:硼替佐米联合化疗及靶向治疗药物为复发难治性ALL的治疗提供了新策略。

Objective:To observe the effect of bortezomib combined with chemotherapy in patients with relapsed and refractory acute lymphoblastic leukemia(ALL). Methods:Three cases of relapsed and refractory ALL were treated with bortezomib(1.3 mg·m-2 dose, day 1,4,8,11) in combination with DOLP(doxorubicin 60 mg·m-2 dose, day 1 to 3, vincristine 2 mg dose, day 1,8,15,22, L-asparaginase 2 000 IU·m-2 dose, day 2,8,15,21, dexamethasone 10 mg dose, day 1 to 14), One case of relapsed and refractory ALL was treated with bortezomib (1.3 mg·m-2 dose, day 1,4,8,11) in combination with COMEP (cyclophosphamide 750 mg·m-2 dose, day 1,3, mitoxantrone 4 mg dose, day 1 to 4, dexamethasone 10 mg dose, day 1 to 14, etoposide 0.1 g dose, day 1 to 4, vincristine 2 mg dose, day 1,8,15,22). The curative effects by peripheral blood, bone marrow cell morphology, immunophenotyping, cytogenetics, and detected NFκB expression level before and after chemotherapy were evaluated. Results:2 cases of 3 cases who received bortezomib combined with DOLP regimen had complete remission with a course of chemotherapy, 1 case had partial remission, 1 case who received bortezomib combined with COMEP regimen did not have response with one course of chemotherapy. Conclusion:Bortezomib combined with chemotherapy and targeted therapy drugs can provide new strategies for the treatment of relapsed and refractory ALL.

参考文献:

[1] ZHAO J,WANG C,SONG Y,et al.Treatment of refractory/relapsed adult acute lymphoblastic leukemia with bortezomib-based chemotherapy[J].Int J Gen Med,2015,12(8):211-214.
[2] DEWAR R,CHEN S T,YECKES-RODIN H,et al.Bortezomib treatment causes remission in a Ph+ALL patient and reveals FoxO as a theranostic marker[J].Cancer Biol Ther,2011,11(6):552-558.
[3] HU X,XU J,SUN A,et al.Successful T-cell acute lymphoblastic leukemia treatment with proteasome inhibitor bortezomib based on evaluation of nuclear factor-κB activity[J].Leuk Lymphoma,2011,52(12):2393-2395.
[4] 朱文艳,王志清,华海应.急性淋巴细胞性白血病13个月后初次缓解1例并文献复习[J].现代医学,2015,43(9):1163-1164.
[5] KANE R C,BROSS P F,FARRELL A T,et al.Velcade:U.S. FDA approval for the treatment of multiple myeloma progressing on prior therapy[J].Oncologist,2003,8(6):508-513.
[6] HOUGHTON P J,MORTON C L,KOLB E A,et al.Initial testing (stage 1) of the proteasome inhibitor bortezomib by the pediatric preclinical testing program[J].Pediatr Blood Cancer,2008,50(1):37-45.
[7] WALKER A R,KLISOVIC R B,GARZON R,et al.Phase Ⅰ study of azacitidine and bortezomib in adults with relapsed or refractory acute myeloid leukemia[J].Leuk Lymphoma,2014,55(6):1304-1308.
[8] MESSINGER Y H,GAYNON P S,SPOSTO R,et al.Bortezomib with chemotherapy is highly active in advanced B-precursor acute lymphoblastic leukemia:therapeutic advances in childhood leukemia & lymphoma (TACL) study[J].Blood,2012,120(2):285-290.
[9] CORTES J,THOMAS D,KOLLER C,et al.Phase I study of bortezomib in refractory or relapsed acute leukemias[J].Clin Cancer Res,2004,10(10):3371-3376.
[10] KOYAMA D,KIKUCHI J,HIRAOKA N,et al.Proteasome inhibitors exert cytotoxicity and increase chemosensitivity via transcriptional repression of Notch1 in T-cell acute lymphoblastic leukemia[J].Leukemia,2014,28(6):1216-1226.
[11] BASTIAN L,HOF J,PFAU M,et al.Synergistic activity of bortezomib and HDACi in preclinical models of B-cell precursor acute lymphoblastic leukemia via modulation of p53,PI3K/AKT,and NF-κB[J].Clin Cancer Res,2013,19(6):1445-1457.
[12] ROMANO M F,PETRELLA A,BISOGNI R,et al.Effect of NF-kappaB/Rel inhibition on spontaneous vs chemotherapy-induced apoptosis in AML and normal cord blood CD34+ cells[J].Leukemia,2003,17(6):1190-1192.
[13] MIN D J,MOSKOWITZ N P,BROWNSTEIN C,et al.Diverse pathways mediate chemotherapy-induced cell death in acute lymphoblastic leukemia cell lines[J].Apoptosis,2006,11(11):1977-1986.
[14] 徐晶晶,胡晓慧,沈雅颖,等.一例难治性急性T淋巴细胞白血病硼替佐米联合化疗治疗临床分析[J].中华血液学杂志,2011,32(10):697-698.
[15] WANG Z,ZHU S,ZHANG G,et al.Inhibition of autophagy enhances the anticancer activity of bortezomib in B-cell acute lymphoblastic leukemia cells[J].Am J Cancer Res,2015,5(2):639-650.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 403328 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364