中国医药科学2025，Vol.15Issue(2)：109-113,5.DOI:10.20116/j.issn2095-0616.2025.02.26
维奈克拉联合阿扎胞苷治疗急性髓系白血病的临床效果分析
Clinical efficacy analysis of venetoclax combined with azacytidine in the treatment of acute myeloid leukemia
摘要
Abstract
Objective To analyze the clinical efficacy of venetoclax combined with azacytidine in the treatment of acute myeloid leukemia(AML)and investigate the related impacting factors.Methods A total of 52 AML patients admitted to and treated in the Huizhou First Hospital from July 1,2022 to December 31,2023 were selected as the research object,and they were divided into the observation group(n=26)and the control group(n=26)according to the random number table method.The control group was treated with azacytidine,while the observation group was treated with venetoclax on the basis of the former.28 days was a course of treatment,and all patients completed at least 1 course of treatment.The clinical efficacy,adverse reactions and overall survival(OS)of the two groups were compared.The impacting factors of patients'OS were analyzed by single factor analysis,and the difference indices were included in COX regression model to explore the factors impacting the clinical efficacy of AML patients.Results There were statistically significant difference in the distribution contrast of therapeutic reaction between the two groups(P<0.05),in which the overall response rate(ORR)of the observation group was higher than that of the control group,with statistically significant difference(P<0.05).There were no statistically significant differences in the total incidence of gradeⅢor above bone marrow suppression and non-hematological toxicity between the two groups(P>0.05).By the end of follow-up,the OS rate in the observation group was higher than that in the control group,with statistically significant difference(Log-rankχ2=48.883,P<0.001).The univariate analysis of OS showed that the risk stratification of European leukemia network(ELN),the initial number of bone marrow primordial cells,the mutation of tumor protein 53(TP53)gene,the comprehensive minimal residual disease(MRD)of bone marrow,the therapeutic regimen and the treatment course were the risk factors that impacted the OS of AML patients(P<0.1).Multivariate analysis showed that ELN-high-risk,MRD-positive and therapeutic regimen-azacytidine were the important risk factors for the decrease of OS rate in AML patients(P<0.05).Conclusion Venetoclax combined with azacytidine is safe in the treatment of elderly AML patients who are not suitable for strong chemotherapy,and the ORR and OS rate increase.Their survival situation is impacted by ELN risk stratification,MRD status and therapeutic regimen.关键词
急性髓系白血病/维奈克拉/阿扎胞苷/生存期/影响因素Key words
Acute myeloid leukemia/Venetoclax/Azacytidine/Survival/Impacting factor分类
医药卫生引用本文复制引用
郑方英,王春莲,黄浩元..维奈克拉联合阿扎胞苷治疗急性髓系白血病的临床效果分析[J].中国医药科学,2025,15(2):109-113,5.基金项目
广东省惠州市医疗卫生领域科技计划项目(2022CZ010149). （2022CZ010149）
