Blinatumomab治疗急性B淋巴细胞白血病的研究进展*

李雪源 郭文璟 冯四洲

李雪源, 郭文璟, 冯四洲. Blinatumomab治疗急性B淋巴细胞白血病的研究进展*[J]. 中国肿瘤临床, 2023, 50(22): 1159-1163. doi: 10.12354/j.issn.1000-8179.2023.20231028
引用本文: 李雪源, 郭文璟, 冯四洲. Blinatumomab治疗急性B淋巴细胞白血病的研究进展*[J]. 中国肿瘤临床, 2023, 50(22): 1159-1163. doi: 10.12354/j.issn.1000-8179.2023.20231028
Xueyuan Li, Wenjing Guo, Sizhou Feng. Research progress in the treatment of B-cell acute lymphoblastic leukemia withblinatumomab[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(22): 1159-1163. doi: 10.12354/j.issn.1000-8179.2023.20231028
Citation: Xueyuan Li, Wenjing Guo, Sizhou Feng. Research progress in the treatment of B-cell acute lymphoblastic leukemia withblinatumomab[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(22): 1159-1163. doi: 10.12354/j.issn.1000-8179.2023.20231028

Blinatumomab治疗急性B淋巴细胞白血病的研究进展*

doi: 10.12354/j.issn.1000-8179.2023.20231028
基金项目: 本文课题受细胞生态海河实验室创新基金项目(编号:22HHXBSS00036)资助
详细信息
    作者简介:

    李雪源:专业方向为血液系统恶性肿瘤的研究

    通讯作者:

    冯四洲 szfeng@ihcams.ac.cn

Research progress in the treatment of B-cell acute lymphoblastic leukemia withblinatumomab

Funds: This work was supported by Haihe Laboratory of Cell Ecosystem Innovation Fund (No.22HHXBSS00036)
More Information
  • 摘要: 急性B淋巴细胞白血病(B-cell acute lymphoblastic leukemia,B-ALL)是一种恶性血液病。研究发现,以CD19作为治疗靶点的贝林妥欧单抗(blinatumomab)作为异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)的桥梁显著改善了复发/难治性急性B淋巴细胞白血病(relapsed/refractory acute lymphoblastic leukemia,R/R B-ALL)患者的预后,其在新诊断急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)中与细胞毒性化疗药物或其他免疫治疗药物联用,在确保疗效的同时降低了方案的不良反应,在费城染色体阳性(Philadelphia chromosome-positive,Ph+)ALL患者中与二代/三代酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)联合应用,有望使患者后期无需移植治疗。此外,治疗后微小残留病变(minimal residual disease,MRD)对患者的复发和长期生存(overall survival,OS)具有显著影响,blinatumomab可提高ALL患者的MRD转阴率,保障了患者的远期预后。本综述重点介绍blinatumomab在B-ALL不同患者群体中的临床研究及相关进展。

     

  • 表  1  新诊断Ph- B-ALL主要研究

    临床研究 入组数(例) 年龄(范围) 治疗方案 MRD阴
    性率(%)
    EFS/RFS/
    DFS/PFS
    OS率 ≥3级CRS
    (%)
    ≥3级NAE
    (%)
    Boissel等[10] 95 中位年龄35
    (18~60)岁
    blinatumomab加入巩固
    与维持治疗
    0.74 18个月DFS
    78.8%
    18个月OS率92.1% 0 0.06
    Litzow等[11] 488 中位年龄51
    (30~70)岁
    常规化疗+/-blinatumomab mOS率未达到
    Jabbour等[12] 38 中位年龄37
    (29~45)岁
    hyper-CVAD+blinatumomab
    0.97 3年RFS 73% 3年OS率81% 0.03 0.11
    Jabbour等[13] 80 中位年龄68
    (63~72)岁
    mini-hyper-CVD+ 奥英
    妥珠单抗,+/-blinatumomab
    0.94 2年PFS 58.2% 2年OS率63.6% 0 0.22
    Van der Slui等[15] 30 <1岁 interfant06方案+blinatumomab
    0.53 5年PFS 44.0% 5年OS率46.0% 0 0
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出版历程
  • 收稿日期:  2023-11-07
  • 录用日期:  2023-11-20
  • 修回日期:  2023-11-07

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