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其临床症状、缩小脾脏。血小板计数<50×10 L 不应 髓纤维化的有效性和安全性[J]. 青岛大学学报(医学
视为芦可替尼治疗的绝对禁忌证,临床上可根据患者的 版),2025,61(1):29-33.
情况评估风险与收益,在患者知情同意下,试行芦可替 [12] US Department of Health and Human Services,National
尼治疗 。但鉴于本研究仅纳入2例血小板计数<50× Institutes of Health,National Cancer Institute. Common
[11]
Terminology Criteria for Adverse Events(CTCAE),ver‐
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10 L 的患者,尚需扩大样本量进一步证实。
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综上所述,芦可替尼能有效改善 MF 患者的临床症 sion 4.03[EB/OL]. [2024-12-01].http://www.eortc.be/ser‐
vices/doc/ctc/ctcae_4.03_2010-06-14_quickreference_5x7.
状,缩小脾脏,稳定甚至改善 MF 分级,有望为 MF 患者
pdf.
带来长期生存获益;ADR主要为贫血、血小板减少、感染 [13] WHO.The use of the WHO-UMC system for standardised
及胃肠道不适。本研究的局限性为:(1)本文为单中心 case causality assessment[EB/OL]. [2024-12-02]. https://
回顾性研究,纳入的样本量较少,随访时间较短,结果可 www.who.int/publications/m/item/WHO-causality-assess-
能存在一定偏倚;(2)由于芦可替尼作为MF一线治疗的 ment.
疗效数据已明确,且有研究以单药芦可替尼的脾脏反应 [14] KVASNICKA H M,THIELE J,BUESO-RAMOS C E,et
率、生存期为参照 [9,15,17] ,所以本研究未设置对照组。因 al. Long-term effects of ruxolitinib versus best available
此,本文所得结论尚需更多大样本(尤其是纳入血小板 therapy on bone marrow fibrosis in patients with myelofi‐
计数<50×10 L 患者)、多中心对照研究进一步证实。 brosis[J]. J Hematol Oncol,2018,11(1):42.
9
-1
参考文献 [15] 张雪皎,王跃,谭云山,等. 芦可替尼治疗骨髓纤维化患
者的疗效及其预测模型[J]. 中国癌症防治杂志,2021,13
[ 1 ] MEAD A J,MULLALLY A. Myeloproliferative neoplasm (4):370-375.
stem cells[J]. Blood,2017,129(12):1607-1616.
[16] JUNG C W,SHIH L Y,XIAO Z J,et al. Efficacy and
[ 2 ] TEFFERI A,GUGLIELMELLI P,LARSON D R,et al. safety of ruxolitinib in Asian patients with myelofibrosis
Long-term survival and blast transformation in molecu‐
[J]. Leuk Lymphoma,2015,56(7):2067-2074.
larly annotated essential thrombocythemia,polycythemia [17] HOW J,HOBBS G S. A practical guide for using myelofi‐
vera,and myelofibrosis[J]. Blood,2014,124(16):2507-
brosis prognostic models in the clinic[J]. J Natl Compr
2513.
Canc Netw,2020,18(9):1271-1278.
[ 3 ] ZAHR A A,SALAMA M E,CARREAU N,et al. Bone [18] 罗洁,谭雅娴,黄继贤,等. 芦可替尼治疗骨髓纤维化阶
marrow fibrosis in myelofibrosis:pathogenesis,prognosis
段性疗效及安全性评估[J]. 实用医学杂志,2021,37(9):
and targeted strategies[J]. Haematologica,2016,101(6): 1187-1192.
660-671. [19] GUPTA V,GRIESSHAMMER M,MARTINO B,et al.
[ 4 ] VERSTOVSEK S,GOTLIB J,MESA R A,et al. Long- Poster presentation at 23rd congress of the European
term survival in patients treated with ruxolitinib for myelo‐ Hematology Association[M]. Stockholm:Sweden,2018:
fibrosis:COMFORT-Ⅰ and-Ⅱ pooled analyses[J]. J He‐ PF616.
matol Oncol,2017,10(1):156. [20] 于淮海,孙雨飞,金昌洙,等. 信号传导及转录激活因子
[ 5 ] 中华医学会血液学分会白血病淋巴瘤学组,肖志坚,王 信号通路在自然杀伤细胞研究中的进展[J]. 转化医学杂
建祥. 原发性骨髓纤维化诊断与治疗中国指南:2019年 志,2018,7(3):189-193.
版[J]. 中华血液学杂志,2019,40(1):1-7. [21] YANG Y F,LUO H M,ZHENG Y H,et al. Low-dose
[ 6 ] 中国临床肿瘤学会(CSCO). CSCO 恶性血液病诊疗指 ruxolitinib shows effective in treating myelofibrosis[J].
南:2024[M].北京:人民卫生出版社,2024:345-368. Ann Hematol,2021,100(1):135-141.
[ 7 ] VERSTOVSEK S,MESA R A,GOTLIB J,et al. A [22] ELLI E M,BARATÈ C,MENDICINO F,et al. Mecha‐
double-blind,placebo-controlled trial of ruxolitinib for nisms underlying the anti-inflammatory and immunosup‐
myelofibrosis[J]. N Engl J Med,2012,366(9):799-807. pressive activity of ruxolitinib[J]. Front Oncol,2019,9:
[ 8 ] HARRISON C N,VANNUCCHI A M,KILADJIAN J J, 1186.
et al. Long-term findings from COMFORT-Ⅱ,a phase 3 [23] BARONE M,CATANI L,RICCI F,et al. The role of cir‐
study of ruxolitinib vs best available therapy for myelofi‐ culating monocytes and JAK inhibition in the infectious-
brosis[J]. Leukemia,2016,30(8):1701-1707. driven inflammatory response of myelofibrosis[J]. Onco‐
[ 9 ] 金洁,杜欣,周道斌,等 . JAK 抑制剂芦可替尼治疗中国 immunology,2020,9(1):1782575.
骨髓纤维化患者的疗效和安全性:A2202随访一年结果 [24] AL-ALI H K,GRIESSHAMMER M,FOLTZ L,et al.
[J]. 中华血液学杂志,2016,37(10):858-863. Primary analysis of JUMP,a phase 3b,expanded-access
[10] MASAROVA L,MESA R A,HERNÁNDEZ-BOLUDA J study evaluating the safety and efficacy of ruxolitinib in
C,et al. Severe thrombocytopenia in myelofibrosis is patients with myelofibrosis,including those with low
more prevalent than previously reported[J]. Leuk Res, platelet counts[J]. Br J Haematol,2020,189(5):888-903.
2020,91:106338. (收稿日期:2024-12-16 修回日期:2025-06-07)
[11] 张奇,崔渤莉,费海荣,等. 芦可替尼治疗血小板减少骨 (编辑:陈 宏)
中国药房 2025年第36卷第14期 China Pharmacy 2025 Vol. 36 No. 14 · 1785 ·