维奈克拉致Ph样急性淋巴细胞白血病肿瘤溶解综合征1例
Venetoclax induced Ph-like acute lymphoblastic leukemia tumor lysis syndrome:A case report
丁月玲 1成志勇 2付建珠 2李宗英 1丁玉芝 1柳倩2
作者信息
- 1. 定州市人民医院血液内科,河北定州 073000
- 2. 保定市第一医院血液内科,河北 保定 071000
- 折叠
摘要
维奈克拉是一种选择性B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)抑制剂,目前广泛应用于造血系统恶性肿瘤治疗,疗效良好.其主要不良反应包括血细胞减少、感染、消化道反应、电解质紊乱等,在慢性淋巴细胞白血病中可能出现严重肿瘤溶解综合征.2023年1月6日保定市第一医院收治1例75岁男性难治复发Ph样急性淋巴细胞白血病患者,在应用维奈克拉100 mg后3.5 h出现典型的肿瘤溶解综合征,伴有急性肾功能衰竭、高钾、低钙、少尿、高尿酸,并迅速出现严重的血细胞减少、粒细胞缺乏.经对症支持治疗后,肾功能恢复正常,但仍持续全血细胞减少伴严重感染,最终死亡.
Abstract
Venetoclax is a selective B-cell lymphoma-2(Bcl-2)inhibitor,widely used in the treatment of hematologic malignancies with good efficacy.Its primary adverse effects include cytopenias,infections,gastrointestinal reactions,and electrolyte disturbances,with the potential for severe tumor lysis syndrome in chronic lymphocytic leukemia.The patient,a 75-year-old male,was admitted to Baoding No.1 Hospital on January 6,2023,with a diagnosis of refractory relapsed Ph-like acute lymphoblastic leukemia.Tumor lysis syndrome with acute renal failure,hyperkalemia,hypocalcemia,oliguria,hyperuricemia,and rapid onset of severe cytopenia and neutropenia occurred 3.5 hours after administering 100 mg of venetoclax.Despite symptomatic and supportive treatment leading to the recovery of renal function,the patient continued to experience persistent pancytopenia with severe infections and ultimately died.
关键词
急性淋巴细胞白血病/肿瘤溶解综合征/维奈克拉Key words
acute lymphoblastic leukemia/tumor lysis syndrome/venetoclax引用本文复制引用
基金项目
河北省重点研发计划项目(223777105D)
保定市科技计划项目(2341ZF232)
出版年
2024
国家科技期刊平台
NSTL
万方数据