维奈克拉联合表观遗传学药物治疗急性髓系白血病的研究进展

Research progress of venetoclax in combination with epigenetic drugs for acute myeloid leukemia therapy

  • 摘要: 急性髓系白血病(acute myeloid leukemia,AML)是一种造血干细胞克隆性恶性疾病,传统治疗效果欠佳,老年及不适合强化疗的患者预后尤差。维奈克拉作为高选择性BCL-2 抑制剂,通过诱导肿瘤细胞凋亡发挥抗白血病作用。近年来,维奈克拉联合表观遗传学药物治疗AML取得显著进展。表观遗传学药物如去甲基化药物、组蛋白去乙酰化酶抑制剂等,可调控基因表达,恢复细胞正常分化。维奈克拉与表观遗传学药物(如去甲基化药物阿扎胞苷/地西他滨、组蛋白去乙酰化酶抑制剂) 联合应用可产生协同增效作用,重塑白血病细胞表观遗传状态,增强其凋亡敏感性。早期临床试验证实,该联合方案能够提高AML患者的缓解率,延长生存期。本文综述了表观遗传学药物与维奈克拉联合治疗AML的协同机制及临床进展,以期为临床实践和后续研究提供参考。

     

    Abstract: Acute myeloid leukemia (AML) is a clonal malignant disease of hematopoietic stem cells, associated with suboptimal responses to conventional therapy, particularly in elderly patients and those unfit for intensive chemotherapy, who experience poorer outcomes. Venetoclax, a highly selective BCL-2 inhibitor, exerts its antileukemic effect by inducing tumor cell apoptosis. In recent years, significant progress has been made in the treatment of AML using Venetoclax in combination with epigenetic drugs. Epigenetic drugs, such as DNA methyltransferase inhibitors (e. g., azacitidine and decitabine) and histone deacetylase inhibitors, can regulate gene expression and restore normal cell differentiation. The combination of venetoclax and epigenetic agents shows marked synergistic efficacy, remodeling the epigenetic landscape of leukemia cells and sensitizing them to apoptosis. Early clinical trials have confirmed that this combination can improve the remission rate and prolong the survival of AML patients.This review aims to describe the synergistic mechanisms and clinical research progress of epigenetic drugs in combination with Venetoclax for the treatment of acute myeloid leukemia, providing references for clinical practice and further research.

     

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