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.
QI Wen-Jing,XU Xue-Ju,LI Bai et al. Application of high-throughput drug sensitivity testing in children with relapsed and refractory acute leukemia[J]. CJCP, 2024, 26(10): 1093-1100.
QI Wen-Jing,XU Xue-Ju,LI Bai et al. Application of high-throughput drug sensitivity testing in children with relapsed and refractory acute leukemia[J]. CJCP, 2024, 26(10): 1093-1100.
Brown P, Inaba H, Annesley C, et al. Pediatric acute lymphoblastic leukemia, version 2.2020, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2020, 18(1): 81-112. PMID: 31910389. DOI: 10.6004/jnccn.2020.0001.
Lv W, Chen T, Wang S, et al. Feasibility of high-throughput drug sensitivity screening (HDS)-guided treatment for children with refractory or relapsed acute myeloid leukemia[J]. Front Pediatr, 2023, 11: 1117988. PMID: 36873635. PMCID: PMC9982438. DOI: 10.3389/fped.2023.1117988.
Li L, Wang W, Liang L, et al. Application of high-efficiency cell expansion and high-throughput drug sensitivity screening for leukemia treatment[J]. Dis Markers, 2022, 2022: 4052591. PMID: 35845130. PMCID: PMC9277151. DOI: 10.1155/2022/4052591.
Lin N, Liu Z, Li Y, et al. Determining the appropriate treatment for T-cell acute lymphoblastic leukemia with SET-CAN/NUP214 fusion: perspectives from a case report and literature review[J]. Front Oncol, 2021, 11: 651494. PMID: 33869055. PMCID: PMC8044795. DOI: 10.3389/fonc.2021.651494.
Lin N, Yan X, Cai D, et al. Leukemia with TCF3-ZNF384 rearrangement as a distinct subtype of disease with distinct treatments: perspectives from a case report and literature review[J]. Front Oncol, 2021, 11: 709036. PMID: 34395283. PMCID: PMC8357369. DOI: 10.3389/fonc.2021.709036.
Gandolfi S, Laubach JP, Hideshima T, et al. The proteasome and proteasome inhibitors in multiple myeloma[J]. Cancer Metastasis Rev, 2017, 36(4): 561-584. PMID: 29196868. DOI: 10.1007/s10555-017-9707-8.
Bertaina A, Vinti L, Strocchio L, et al. The combination of bortezomib with chemotherapy to treat relapsed/refractory acute lymphoblastic leukaemia of childhood[J]. Br J Haematol, 2017, 176(4): 629-636. PMID: 28116786. DOI: 10.1111/bjh.14505.
Horton TM, Whitlock JA, Lu X, et al. Bortezomib reinduction chemotherapy in high-risk ALL in first relapse: a report from the Children's Oncology Group[J]. Br J Haematol, 2019, 186(2): 274-285. PMID: 30957229. PMCID: PMC6606340. DOI: 10.1111/bjh.15919.
