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维奈克拉与肿瘤溶解综合征病理生理研究进展

Advances In The Pathophysiological Research Of Venetoclax And TumorLysis Syndrome

  • 摘要: 维奈克拉(Venetoclax)通过选择性靶向抑制B细胞淋巴瘤-2(B CELL LYMPHOMA-2,BCL-2)信号通路,临床用于造血系统恶性肿瘤治疗,副作用包括血细胞减少、骨髓抑制及消化道反应等,部分患者因维奈克拉快速诱导肿瘤细胞凋亡,大量肿瘤细胞短时间破坏,引发的代谢急症,导致急性肾功能损伤、电解质紊乱、心律失常甚至死亡,出现肿瘤溶解综合征(Tumor lysis syndrome,TLS)。本文系统阐述了维奈克拉诱导TLS发生的病理过程、分子机制、临床发病及预防策略,为临床合理应用提供了理论依据。

     

    Abstract: Venetoclax is clinically used in the treatment of hematopoietic malignant tumors by selectively targeting and inhibiting the B cell lymphoma-2 signaling pathway, and the side effects include hematopoiesis, bone marrow suppression, and gastrointestinal tract reactions, etc.In some patients, due to the rapid apoptosis induced by Venetoclax, a large number of tumor cells are destroyed in a short period of time, resulting in acute kidney injury, cardiac rhythm disorder, and even death, which leads to tumor lysis syndrome.In some patients, the rapid apoptosis of tumor cells induced by venetoclax and the short-term destruction of a large number of tumor cells resulted in metabolic emergencies triggered by venetoclax, leading to acute renal Impairment, electrolyte disorders, cardiac arrhythmia and even death, and the emergence of Tumor Lysis Syndrome.In this paper, the pathological process, molecular mechanism, clinical pathogenesis and preventive strategy of TLS induced by venetoclax are systematically described, which provides a theoretical basis for rational clinical application.

     

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