[Application of high-throughput drug sensitivity testing in children with relapsed and refractory acute leukemia].

Q3 Medicine 中国当代儿科杂志 Pub Date : 2024-10-15 DOI:10.7499/j.issn.1008-8830.2406014

Wen-Jing Qi, Xue-Ju Xu, Bai Li, Tao Wang, Guang-Yao Sheng, Ping Zhu, Chun-Mei Wang

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Abstract

Objectives: To explore the current application of high-throughput drug sensitivity (HDS) testing in children with relapsed and refractory acute leukemia (RR-AL) and analyze the feasibility of salvage treatment plans.

Methods: A retrospective collection of clinical data from children with RR-AL who underwent HDS testing at the Department of Children's Hematology and Oncology of the First Affiliated Hospital of Zhengzhou University from November 2021 to October 2023 was conducted, followed by an analysis of drug sensitivity results and treatment outcomes.

Results: A total of 17 children with RR-AL underwent HDS testing, including 7 cases of relapsed refractory acute myeloid leukemia and 10 cases of relapsed refractory acute lymphoblastic leukemia. The detection rate of highly sensitive chemotherapy drugs/regimens was 53% (9/17), while the detection rate of moderately sensitive chemotherapy drugs/regimens was 100% (17/17). Among the 17 RR-AL patients with highly and moderately sensitive chemotherapy drugs and regimens, the MOACD regimen (mitoxantrone + vincristine + cytarabine + cyclophosphamide + dexamethasone) accounted for 100%, with the highest inhibition rate for single-agent mitoxantrone (94%, 16/17), and the highest inhibition rate for targeted therapy being bortezomib (94%, 16/17). Nine patients adjusted their chemotherapy based on HDS testing results, with 4 undergoing hematopoietic stem cell transplantation. Four patients achieved disease-free survival, while 5 died. Eight patients received empirical chemotherapy, with 2 undergoing hematopoietic stem cell transplantation; 4 achieved disease-free survival, while 4 died.

Conclusions: HDS testing can identify highly sensitive drugs/regimens for children with RR-AL, improving the rate of re-remission and creating conditions for subsequent hematopoietic stem cell transplantation.

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[高通量药物敏感性测试在复发和难治性急性白血病患儿中的应用]。

目的探讨高通量药物敏感性（HDS）检测在复发性和难治性急性白血病（RR-AL）患儿中的应用现状，分析挽救治疗方案的可行性：方法：回顾性收集2021年11月至2023年10月期间在郑州大学第一附属医院儿童血液肿瘤科接受HDS检测的RR-AL患儿的临床资料，并对药敏结果和治疗效果进行分析：结果：共有17例RR-AL患儿接受了HDS检测，其中包括7例复发难治性急性髓性白血病患儿和10例复发难治性急性淋巴细胞白血病患儿。高敏化疗药物/方案的检出率为53%（9/17），中敏化疗药物/方案的检出率为100%（17/17）。在17名化疗药物和方案高度敏感和中度敏感的RR-AL患者中，MOACD方案（米托蒽醌+长春新碱+阿糖胞苷+环磷酰胺+地塞米松）占100%，单药米托蒽醌的抑制率最高（94%，16/17），靶向治疗的抑制率最高的是硼替佐米（94%，16/17）。9名患者根据HDS检测结果调整了化疗方案，其中4人接受了造血干细胞移植。4名患者实现了无病生存，5名患者死亡。8名患者接受了经验性化疗，其中2人进行了造血干细胞移植；4人获得无病生存，4人死亡：结论：HDS检测可为RR-AL患儿确定高敏感药物/方案，提高再缓解率，为后续造血干细胞移植创造条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

中国当代儿科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

1.50

自引率

0.00%

发文量

5006

期刊介绍： The Chinese Journal of Contemporary Pediatrics (CJCP) is a peer-reviewed open access periodical in the field of pediatrics that is sponsored by the Central South University/Xiangya Hospital of Central South University and under the auspices of the Ministry of Education of China. It is cited as a source in the scientific and technological papers of Chinese journals, the Chinese Science Citation Database (CSCD), and is one of the core Chinese periodicals in the Peking University Library. CJCP has been indexed by MEDLINE/PubMed/PMC of the American National Library, American Chemical Abstracts (CA), Holland Medical Abstracts (EM), Western Pacific Region Index Medicus (WPRIM), Scopus and EBSCO. It is a monthly periodical published on the 15th of every month, and is distributed both at home and overseas. The Chinese series publication number is CN 43-1301/R；ISSN 1008-8830. The tenet of CJCP is to “reflect the latest advances and be open to the world”. The periodical reports the most recent advances in the contemporary pediatric field. The majority of the readership is pediatric doctors and researchers.