在患有急性淋巴细胞白血病的儿童中停止阿斯巴拉金酶的复发风险和结果
Xingchen Wang1,2, Chenmeng Liu1,2, Yunlong Chen1,2
1State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China.
Annals of hematology
|November 4, 2025
概括
对儿科急性淋巴细胞白血病 (ALL) 停止阿斯巴拉基纳斯治疗会增加复发风险,并恶化存活率. 通过替代配方维持治疗强度对于ALL患者的更好的结果至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 血液学 血液学 血液学
- 癌症治疗方法 癌症治疗方法
背景情况:
- 阿斯巴拉金酶对于治疗儿科急性淋巴细胞白血病 (ALL) 是至关重要的.
- 由于毒性而停止治疗可能会对患者的结果产生负面影响,并增加复发风险.
研究的目的:
- 调查停用阿斯巴拉基纳斯对儿科ALL患者治疗结果的影响.
- 在这个人群中确定阿斯巴拉基纳斯停止治疗的预测因素.
主要方法:
- 根据CCCG-ALL-2015协议治疗的993名儿科ALL患者的回顾性分析.
- 对患者进行了复发,死亡,二次恶性瘤或随访结束的跟踪.
- 统计分析包括对截断和非截断的阿斯巴拉金酶组之间的结果进行比较.
主要成果:
- 在4.0%的患者中断了阿斯巴拉金酶治疗,主要是由于过敏或胰腺炎.
- 停止治疗的患者的复发率在6年内累计显著增加 (31.5%对17.5%),无事件和整体存活率较低.
- 较低的阿斯巴拉基纳斯剂量 (<53%) 与更高的复发率 (32.1%与14.0%) 有关.
- 老年,更高的MRD水平和更高的阿斯巴拉金酶暴露预测了停止治疗.
结论:
- 停用阿斯帕拉基纳斯与儿科ALL的较差结果有关.
- 通过替代配方维持治疗强度至关重要.
- 需要进一步研究最佳的阿斯巴拉基纳斯剂量和毒性管理.
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