意大利双重暴露慢性淋巴细胞白血病患者的临床结果
Francesco Autore1, Andrea Visentin2, Candida Vitale3,4
1Department of Laboratory and Haematological Sciences, Haematology Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
Hematological oncology
|March 4, 2026
概括
对于慢性淋巴细胞白血病患者在两种抑制剂后复发,随后使用抑制剂的治疗比化疗免疫疗法或干细胞移植更有效. 对于这种具有挑战性的临床场景,需要新的治疗方法.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床研究 临床研究
背景情况:
- B细胞受体抑制剂 (BCRi) 和B细胞淋巴瘤-2抑制剂 (BCL2i) 改善了慢性淋巴细胞白血病 (CLL) 的结果.
- 连续BCRi和BCL2i治疗后复发仍然是一个重大的临床挑战.
研究的目的:
- 分析CLL患者在先前暴露于BCRI和BCL2i后接受venetoclax的现实世界结果.
- 为了比较后续治疗选择的疗效,包括抑制剂,化疗免疫疗法和干细胞移植.
主要方法:
- 在153名在意大利接受治疗的CLL患者 (2017年5月至2023年9月) 之前BCRi和BCL2i暴露后的多中心现实研究.
- 对停止使用venetoclax后的结果进行分析,包括随后的治疗和生存数据.
- 在不同治疗组中比较无事件生存 (EFS) 和整体生存 (OS).
主要成果:
- 在153名患者中,104名患者停止了venetoclax;53人接受了随后的治疗 (29名抑制剂,19名化疗免疫疗法,5名HSCT).
- 随后的抑制剂显示,与化疗免疫疗法 (2个月 EFS,5个月 OS) 和HSCT (10个月 EFS,10个月 OS) 相比,EFS (11个月) 和OS (12个月) 的中位数优于化学免疫疗法.
- 在venetoclax期间的疾病进展与随后的EFS较短有关,尽管在统计学上并不显著.
结论:
- 随后使用抑制剂的治疗比化学免疫疗法或HSCT在CLL患者复发后的双重抑制剂治疗更有效.
- 新的治疗策略和临床试验对于解决这一患者群体未满足的需求至关重要.
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