索拉非尼联合阿扎胞苷+低剂量CHG方案治疗难治复发FLT3-ITD阳性AML的临床疗效观察

doi:10.3969/j.issn.2095-1264.2025.02.15

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索拉非尼联合阿扎胞苷+低剂量CHG方案治疗难治复发FLT3-ITD阳性AML的临床疗效观察
DOI:
                        10.3969/j.issn.2095-1264.2025.02.15
                    
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作者单位:邯郸市第一医院 血液内科，河北 邯郸，056000
作者简介:任欣欣，女，硕士，主治医师，研究方向为血液内科疾病诊治。
通讯作者:李焱，男，主任医师，研究方向为血液内科疾病诊治。
中图分类号:R733.7;R979.1
基金项目:

Clinical observation of sorafenib combined with azacitidine and low-dose CHG regimen in the treatment of refractory/relapsed FLT3-ITD-positive AML

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Affiliation:

Department of Hematology, the First Hospital of Handan City, Handan, 056000, Hebei, China

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摘要:

目的探讨索拉非尼联合阿扎胞苷+低剂量CHG方案（重组人粒细胞集落刺激因子+高三尖杉酯碱+阿糖胞苷）治疗难治复发Fms样酪氨酸激酶3基因内部串联重复（FLT3-ITD）阳性急性髓系白血病（AML）的临床疗效。方法选取2020年2月—2022年2月我院收治的17例难治复发FLT3-ITD阳性AML患者为研究对象，采用索拉非尼联合阿扎胞苷+低剂量CHG方案治疗，评价治疗效果、安全性以及治疗前后FLT3、核转录因子-κB（NK-κB）表达水平。结果患者治疗总有效率为82.35%，主要不良反应为骨髓抑制、感染，经治疗后均好转；治疗后FLT3、核转录因子-κB（NK-κB）水平均低于治疗前（P<0.05）。结论索拉非尼联合阿扎胞苷+低剂量CHG方案治疗难治复发FLT3-ITD阳性AML疗效显著，可降低FLT3基因表达水平，值得临床推广应用。

Abstract:

Objective To investigate the clinical efficacy of sorafenib combined with azacytidine and low-dose CHG (recombinant human granulocyte colony stimulating factor+homoharringtonine+cytarabine) in the treatment of refractory/relapsed Fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD)-positive acute myeloid leukemia (AML).Methods Seventeen patients with refractory/relapsed FLT3-ITD-positive AML in our hospital between February 2020 and February 2022 were selected as the research object. All patients were treated with sorafenib plus azacitidine and low-dose CHG regimen. The therapeutic effect and safety of the patients were analyzed, and the expression levels of FLT3 and nuclear transcription factor-κB (NK-κB) before and after treatment were compared.Results The overall response rate (ORR) was 82.35%. The main adverse reactions included myelosuppression and infections, all of which were resolved after treatment. Post-treatment FLT3 and NF-κB expression levels were significantly lower than pre-treatment levels (P<0.05).Conclusion The combination of sorafenib, azacitidine, and low-dose CHG demonstrates significant efficacy in treating refractory/relapsed FLT3-ITD-positive AML, effectively reducing FLT3 gene expression levels, and is worthy of clinical application and promotion.