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JCO:长春新碱对晚期急性淋巴细胞白血病有效

2012-12-14 佚名 丁香园

急性淋巴细胞白血病白血病长春新碱完全缓解
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　　美国Talon Therapeutics公司Susan O’Brien等人在2012年11月19日在线出版的《临床肿瘤学杂志》（Journal of Clinical Oncology）上，发表了一篇关于硫酸长春新碱(VCR)脂质体注射液治疗晚期急性淋巴细胞白血病(ALL)患者的临床试验结果。急性淋巴细胞白血病成年患者病情复发与较高的再诱导治疗

　　美国Talon Therapeutics公司Susan O’Brien等人在2012年11月19日在线出版的《临床肿瘤学杂志》（Journal of Clinical Oncology）上，发表了一篇关于硫酸长春新碱(VCR)脂质体注射液治疗晚期急性淋巴细胞白血病(ALL)患者的临床试验结果。急性淋巴细胞白血病成年患者病情复发与较高的再诱导治疗死亡率、化疗耐药性以及可导致死亡的快速进展间存在联系。硫酸长春新碱脂质体注射液(VSLI)、鞘磷脂与胆固醇纳米长春新碱都有助于增强长春新碱剂量强度和稠度，并可提高药物在靶点组织中的释放。因此研究人员针对多次复发的费城染色体(Ph)呈阴性、复发后对再诱导治疗产生耐受的成年急性淋巴细胞白血病患者，以及/或在造血干细胞移植后出现复发的患者，评价了高剂量VSLI单剂在此类患者中的应用。

　　该项研究为一项多中心关键性临床II期试验，共有65例Ph阴性的ALL成年患者参与，他们均曾出现过再次或更多次的复发情况，或者在接受两次或更多次白血病治疗后病情仍出现进展。在无剂量限制的情况下，按照2.25 mg/m2剂量，每周静脉注射一次VSLI ，直至患者病情缓解、出现进展、发生毒性反应或进行造血干细胞移植。该项研究的主要终点为，取得完全缓解(CR)或不完全血象恢复下的完全缓解(CRi)。

　　在该项研究中，参试患者CR/CRi为20%，总缓解率为35%。研究人员认为， VSLI单剂可作为一种有效的三线、四线以及五线治疗方法，可用于对其他采用单一药物与多药物进行再次诱导治疗产生耐药性的患者。他们发现，患者平均CR/CRi维持时间为23周(浮动范围。5周至66周)；有12例患者在VSLI治疗后进行造血干细胞移植，5例患者长期存活。此外，VSLI的总体耐受性良好，并且其30日死亡率较低(12%)。

　　因此，研究人员认为，针对晚期急性淋巴细胞白血病患者，高剂量VSLI单剂治疗在临床预后方面具有深远意义，包括可形成持久性缓解以及衔接造血干细胞移植。尽管与常规VCR相比，VSLI药物释放量较大，常规VCR单一与累计剂量无法达到同等药物释放量，但在毒理特性方面，VSLI仍具有可预测性、可控性。

原文出处：

O'Brien S, Schiller G, Lister J, Damon L, Goldberg S, Aulitzky W, Ben-Yehuda D, Stock W, Coutre S, Douer D, Heffner LT, Larson M, Seiter K, Smith S, Assouline S, Kuriakose P, Maness L, Nagler A, Rowe J, Schaich M, Shpilberg O, Yee K, Schmieder G, Silverman JA, Thomas D, Deitcher SR, Kantarjian H.High-Dose Vincristine Sulfate Liposome Injection for Advanced, Relapsed, and Refractory Adult Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia.J Clin Oncol. 2012 Nov 19.

    

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    2013-05-10 vera_1203

    #长春新碱#

    0

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    2013-06-08 sunyl07

    #淋巴细胞白血病#

    0

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    2013-01-05 Raven

    Stay inforatmive, San Diego, yeah boy!

    0

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    2013-01-22 lidong40

    #JCO#

    0

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    2012-12-16 wetgdt

    #淋巴细胞#

    0

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JCO:流式细胞术检测有助于AML治疗

      【研究一瞥】     在急性髓系白血病（AML）年轻患者中，早期治疗反应是疾病远期预后的一个强力预测因子。该指标有助于医生判断是否需要对患者施行更为强化的治疗措施。圣犹达儿童研究医院的研究者们开展了一项试验研究，发现了评价早期治疗反应的最佳测试手段，并依此指导后续治疗。    

NEJM:Ponatinib可用于难治性Ph阳性白血病的治疗

       近日一项来自美国M.D.安德森癌症中心的研究表明，Ponatinib在经过多次预先治疗的对酪氨酸激酶抑制剂耐药的Ph阳性白血病患者（包括有BCR-ABL T315I突变、其他突变或无突变的患者）中具有高度活性。相关研究于11月29日发表于新英格兰医学杂志（NEJM）上。       

JCO:VSLI用于晚期ALL患效果积极

美国Talon Therapeutics公司Susan O’Brien等人在2012年11月19日在线出版的《临床肿瘤学杂志》（Journal of Clinical Oncology）上，发表了一篇关于硫酸长春新碱(VCR)脂质体注射液治疗晚期急性淋巴细胞白血病(ALL)患者的临床试验结果。急性淋巴细胞白血病成年患者病情复发与较高的再诱导治疗死亡率、化疗耐药性以及可导致死亡的快速进展间存在联系。

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