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维奈克拉诱导肿瘤溶解综合征病理生理分子机制及防治进展

Pathophysiological Molecular Mechanism and Progress in Prevention and Treatment of Venetoclax-Induced Tumor Lysis Syndrome

  • 摘要: 维奈克拉(Venetoclax)通过选择性靶向抑制B细胞淋巴瘤-2(Bcl-2)信号通路,用于造血系统恶性肿瘤的治疗,其不良反应包括血细胞减少、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,导致大量肿瘤细胞短时间被破坏,引发代谢急症,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(TLS)。本文将系统阐述维奈克拉诱导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 for the treatment of hematopoietic malignancies by selectively targeting and inhibiting the B cell lymphoma-2 signaling pathway. Side effects include hypocytosis, bone marrow suppression, and gastrointestinal tract reactions. In some patients, numerous tumor cells are destroyed within a short time period because of rapid apoptosis induced by venetoclax, resulting in metabolic crises, leading to acute kidney injury, electrolyte disorders, cardiac arrhythmia, and even death, causing tumor lysis syndrome (TLS). In this paper, the pathological process, molecular mechanism, clinical pathogenesis, and preventive strategy of TLS induced by venetoclax are systematically described. This research provides a theoretical basis for the rational clinical application of venetoclax.

     

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