| 引用本文: | 张燕芳,朱晨影,康媛源,苏力德,王茜茜,卢晓阳,那仁满都拉.砷剂联合方案抗血液肿瘤的临床应用与研究进展[J].中国现代应用药学,2023,40(9):1260-1269. |
| ZHANG Yanfang,ZHU Chenying,KANG Yuanyuan,SU Lide,WANG Qianqian,LU Xiaoyang,NARANMANDURA Hua.Clinical Application and Advances of Arsenic Trioxide Combined Regimen Against Hematological Tumors[J].Chin J Mod Appl Pharm(中国现代应用药学),2023,40(9):1260-1269. |
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| 砷剂联合方案抗血液肿瘤的临床应用与研究进展 |
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张燕芳1, 朱晨影2, 康媛源2, 苏力德3, 王茜茜1,2, 卢晓阳1, 那仁满都拉1,2
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1.浙江大学医学院附属第一医院, 杭州 310003;2.浙江大学医学院, 杭州 310058;3.内蒙古国际蒙医医院, 呼和浩特 010000
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| 摘要: |
| 三氧化二砷(砷剂)即中药"砒霜",最初以"毒物"被大众熟知。自20世纪70年代以来,砷剂被发现可靶向治疗急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)并显著提高其治愈率,从而成为肿瘤靶向治疗领域的研究热点。研究表明,砷剂和全反式维甲酸(all-trans retinoic acid,ATRA)均可以特异性降解PML-RARα融合蛋白,其联合方案已成为APL患者的有效治疗选择。此外,砷剂/ATRA方案和砷剂/干扰素α方案分别在非APL的急性髓系白血病和成人T细胞白血病中发挥协同、靶向抗肿瘤作用。砷剂还能诱导活性氧生成、促进肿瘤细胞凋亡,因此砷剂联合Bcl-2抑制剂等药物和天然药物活性成分在多种血液肿瘤中发挥了协同诱导凋亡的作用。本文结合临床前和临床研究,对砷剂联合方案在血液肿瘤中的临床应用和研究进展进行了总结和展望。 |
| 关键词: 三氧化二砷 全反式维甲酸 急性早幼粒细胞白血病 急性髓系白血病 成人T细胞白血病 血液肿瘤 |
| DOI：10.13748/j.cnki.issn1007-7693.20222322 |
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| 基金项目:国家自然科学基金项目(82170143，82003875)；浙江省重点研发计划(2019C04006)；中国博士后科学基金资助项目(2021M702875) |
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| Clinical Application and Advances of Arsenic Trioxide Combined Regimen Against Hematological Tumors |
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ZHANG Yanfang1, ZHU Chenying2, KANG Yuanyuan2, SU Lide3, WANG Qianqian1,2, LU Xiaoyang1, NARANMANDURA Hua1,2
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1.The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;2.Zhejiang University School of Medicine, Hangzhou 310058, China;3.Inner Mongolia International Mongolia Hospital, Hohhot 010000, China
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| Abstract: |
| As a traditional Chinese medicine named "Pishuang", arsenic trioxide(ATO) is well-known for its toxicity. Since the 1970s, ATO has become a research hotspot due to its potent clinical therapeutic benefits for acute promyelocytic leukemia(APL) and remarkably improved curative ratio. It has been demonstrated that both ATO and all-trans retinoic acid(ATRA) can specifically degrade the oncogenic protein PML-RARα, thereby the combination regimen can be an effective treatment option for APL patients in clinic. In addition, the ATO/ATRA regimen and the ATO/interferon alpha regimen also showed synergistic effects in the treatment of non-APL acute myeloid leukemia and adult T-cell leukemia, respectively. Moreover, ATO induced the generation of reactive oxygen species and promoted apoptosis in cancer cells. In light of this, ATO combined with Bcl-2 inhibitor or active ingredients of natural medicine can synergistically induce the apoptosis of various hematological tumors. In this paper, the clinical application and research progress of ATO combined regimen in hematological tumors were summarized and prospected based on preclinical and clinical studies. |
| Key words: arsenic trioxide all-trans retinoic acid acute promyelocytic leukemia acute myeloid leukemia adult T-cell leukemia hematological tumors |
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