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在前线波纳替尼和布利纳图马布治疗后,在Ph + ALL患者中复发的分子特征和预测因素

Nicholas J Short¹, Hagop Kantarjian¹, Ken Furudate¹

¹Department of Leukemia, The University of Texas MD Anderson Cancer Center, Unit 428, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.

Journal of hematology & oncology

|May 14, 2025

概括

诊断时高白细胞计数预测费城染色体阳性急性淋巴细胞白血病 (Ph+ALL) 患者的复发,这些患者接受了无化疗的blinatumomab和ponatinib治疗. 这些患者可能需要替代的前线策略来改善结果.

科学领域:

血液学血液学血液学
在瘤学瘤学.
临床试验临床试验

背景情况:

结合布利纳图马布和激素激酶抑制剂的无化疗疗法对费城染色体阳性急性淋巴细胞白血病 (Ph+ALL) 有希望.
在接受这些新疗法的Ph+ALL患者中,复发的预测因素在很大程度上仍未确定.
了解复发预测因子对于优化治疗策略和改善患者治疗结果至关重要.

研究的目的:

确定预测新诊断的Ph+ALL患者的复发的临床和分子特征,这些患者接受了布利纳图马布和波纳替尼.
评估在未来的临床试验环境中无化疗疗法的疗效和安全性.

主要方法:

一项前性II期临床试验招募了76名新诊断的Ph+ALL.患者.
患者接受了blinatumomab,ponatinib以及用于中枢神经系统 (CNS) 预防的内化疗.
用单变量和多变量方法分析了复发模式和复发的临床/分子预测因素.

主要成果:

三年无事件生存率为78%,整体生存率为88%,复发率为13%.
在多变量分析中,诊断时高白细胞 (WBC) 计数 (≥70 × 10 ^ 9 / L) 与复发风险增加显著相关 (sHR 16.29,P = 0.005).
特别是在中枢神经系统中观察到外骨性复发;在复发时CD19表达仍然很高.

结论:

诊断时的高白血细胞计数是Ph+ALL患者治疗布利纳图马布和波纳替尼的复发的重要预测因素.
在这种情况下,升高的白细胞计数可能会超过基线分子特征的预后重要性.
对于高白细胞计数的Ph+ALL患者,替代前线治疗策略是有必要的,以减轻复发风险.

关键词:

布莱纳图莫马巴姆是什么意思费城染色体是什么意思费城染色体是什么意思波纳替尼布 (Ponatinib) 是一种复发复发的情况

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