雷利度胺治疗恶性血液病的新进展

摘要

雷利度胺是沙利度胺的第二代类似物,属第二代免疫调节药.该药在恶性血液病治疗中的作用机制较复杂,包括直接细胞毒性、对肿瘤免疫的间接作用等,目前已用于多发性骨髓瘤及骨髓增生异常综合症的治疗,且疗效肯定.近几年来的研究结果提示,雷利度胺单药口服可使非霍奇金淋巴瘤、复发难治的霍奇金淋巴瘤、老年急性髓系白血病及初治的慢性淋巴细胞白血病患者获得持久缓解,且不良反应轻微、可控,为血液淋巴系统疾病的治疗带来了新的希望.本文就近5年来雷利度胺在治疗恶性血液病方面的新进展作一综述,以期对本药的应用及恶性血液病的临床治疗提供一定的参考与帮助.%Lenalidomide is an immunomodulatory, antiangiogenic drug that is a structural analog of thalidomide. Studies showed that lenalidomide may work through various mechanisms in hematologic malignancies. These mechanisms involved direct cytotoxicity as well as through indirect effects on tumor immunity etc. It is approved by the Food and Drug Administration for treatment of multiple myeloma and myelodysplastic syndromes, and proved to have a good efficacy. Recent studies demonstrate that oral lenalidomide alone produces durable responses with manageable adverse events in patients with non-Hodgkin' s lymphoma, relapsed/refractory Hodgkin' s lymphoma, chronic lymphocytic leukemia and older patients with acute myeloid leukemia etc, warranting further investigation of treatment for these patients. This review focuses the related studies and the latest progression about lenalidomide in hematological malignancies in order to provide some references and help to the use of lenalidomide for the treatment of hematological malignancies.