Application of high-throughput drug sensitivity testing in children with relapsed and refractory acute leukemia
10.7499/j.issn.1008-8830.2406014
- VernacularTitle:高通量药敏检测技术在儿童复发难治性急性白血病中的应用
- Author:
Wen-Jing QI
1
;
Xue-Ju XU
;
Bai LI
;
Tao WANG
;
Guang-Yao SHENG
;
Ping ZHU
;
Chun-Mei WANG
Author Information
1. 郑州大学第一附属医院儿童血液与肿瘤科,河南郑州 450052
- Keywords:
Relapsed and refractory acute leukemia;
High-throughput;
Drug sensitivity;
Child
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(10):1093-1100
- CountryChina
- Language:Chinese
-
Abstract:
Objective 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.
