Objective: To investigate the short-term efficacy and safety of low-dose venetoclax combined with CHG (cytarabine+homoharringtonine+G-CSF) priming regimen in patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) ineligible for intensive chemotherapy.
Methods: The data of 14 patients with AML or high-risk MDS admitted to the department of hematology/oncology of the First Hospital of Tsinghua University and 2 cooperative institutions from July 2022 to August 2023 were retrospectively analyzed. All the patients were treated with low-dose venetoclax combined with CHG priming regimen and the early induction (one course) efficacy and adverse reactions were observed.
Results: Among the 14 patients, 10 were males and 4 were females, with a median age of 69.5 (46-83) years. After 1 cycle of induction chemotherapy, the complete remission (CR) rate was 64.3% (9/14) and overall response rate (ORR) was 78.6% (11/14). Among the 10 patients with adverse prognosis according to cytogenetics and molecular genetics, the CR rate was 50.0% (5/10), and ORR was 70.0% (7/10). In 7 patients with TP53 mutation, the CR rate was 42.9% (3/7) and ORR was 71.4% (5/7). In the 6 patients with complex karyotype, CR rate was 33.3% (2/6) and ORR was 66.7% (4/6). While the CR rate and ORR of 8 non-complex karyotype patients were both 87.5% (7/8), and the difference in CR rate between patients with complex karyotype and non-complex karyotype was statistically significant ( P < 0.05). The adverse reactions of chemotherapy were tolerable, without early treatment-related deaths.
Conclusion: Low-dose venetoclax combined with CHG priming regimen can be used as an effective treatment for AML and high-risk MDS patients who are ineligible for intensive chemotherapy, and it is safe and worthy of clinical application.
题目: 低剂量维奈克拉联合CHG预激方案治疗不适合强烈化疗AML和高危MDS的近期疗效研究.
目的: 探讨低剂量维奈克拉联合CHG（阿糖胞苷+高三尖杉酯碱+粒细胞集落刺激因子）预激方案治疗不适合强烈化疗急性髓系白血病（AML）和高危骨髓增生异常综合征（MDS）的近期疗效和安全性。.
方法: 回顾性分析2022年7月至2023年8月于清华大学第一附属医院血液肿瘤科和另外两家合作单位住院治疗的14例AML和高危MDS患者的资料。所有患者均采用低剂量维奈克拉联合CHG预激方案诱导治疗，观察入组患者的早期（1个疗程）疗效和不良反应。.
结果: 14例患者中，男性10例，女性4例，中位年龄69.5（46-83）岁，1个疗程完全缓解率为64.3% （9/14），总有效率为78.6%（11/14）。在细胞遗传学和分子生物学分类不良预后的10例患者中，完全缓解率为50.0% （5/10），总有效率70.0%（7/10）。在 TP53突变的7例患者中，完全缓解率为42.9%（3/7），总有效率为71.4%（5/7）。复杂核型患者共有6例，完全缓解率为33.3%（2/6），总有效率为66.7%（4/6）；非复杂核型患者8例，完全缓解率和总有效率均为87.5%（7/8），两组完全缓解率差异具有统计学意义（ P < 0.05）。患者对药物的不良反应能够耐受，无早期治疗相关死亡。.
结论: 低剂量维奈克拉联合CHG预激方案可作为不适合强烈化疗的AML和高危MDS患者的有效治疗方案，安全性良好，值得临床推广和应用。.
Keywords: acute myeloid leukemia; myelodysplastic syndrome; venetoclax; CHG priming regimen; efficacy.