摘要目的:探索维奈克拉联合阿扎胞苷（VA）治疗初诊慢性粒单核细胞白血病（CMML）患者的疗效。方法:回顾性分析河北大学附属医院自2022年2月至2023年3月收治的VA方案治疗的4例初诊CMML-2型（CMML-2）患者的临床资料，并复习相关文献。结果:4例CMML-2型患者在治疗1个疗程后均达到≥部分骨髓缓解（PMR），随着疗程的延长，总反应率（ORR）和完全缓解率分别为100%和50%。在剂量调整方面，通过动态的衰弱评估及不良反应决定维奈克拉剂量及用药天数。2例获CR的患者1例初始应用维奈克拉200 mg 14 d，1例在维奈克拉400 mg 28 d后因血液学不良反应减量为维奈克拉200 mg 14 d，目前均维持完全缓解。最常见的3、4级不良反应是中性粒细胞减少、血小板减少。结论:VA方案一线应用治疗CMML-2型患者较传统单药HMA可能取得更快的缓解，安全性较好。

abstractsObjective:To explore the efficacy of venetoclax plus azacitidine (VA) in the treatment of patients with newly diagnosed chronic myelomonocytic leukemia (CMML).Methods:The clinical data of 4 newly diagnosed CMML-2 patients treated with VA regimen in the Affiliated Hospital of Hebei University from February 2022 to March 2023 were retrospectively analyzed, and the related literature was reviewed.Results:All 4 CMML-2 patients achieved the effect of ≥ partial bone marrow remission (PMR) after 1 course of treatment, and with the deepened extension of treatment course, the overall response rate and complete remission (CR) rate was 100% and 50%, respectively. In terms of dose adjustment, the dose and usage day of venetoclax were determined by using dynamic frailty assessment and adverse events. Among the 2 patients who achieved CR, 1 patient initially received venetoclax 200 mg for 14 days, and 1 patient received venetoclax 400 mg for 28 days and then the usage reduced to venetoclax 200 mg for 14 days due to hematological adverse events. All 4 patients maintained CR status. The most common grade 3 and 4 adverse events were neutropenia and thrombocytopenia.Conclusions:The first-line application of VA regimen in the treatment of newly diagnosed CMML-2 patients may achieve faster remission and better safety compared with traditional HMA monotherapy.