Abstract：
Waldenström macroglobulinemia (WM) is a rare form of non-Hodgkin B-cell lymphoma with a variable clinical presentation that can impact a patient\'s quality of life by causing anemia, peripheral neuropathy, serum hyperviscosity, extramedullary disease, and other symptoms. There are several safe and effective treatment regimens for patients with WM, and the choice of therapy should be made in a personalized fashion considering the patient\'s symptoms, comorbidities, and genomic profile. Bruton tyrosine kinase (BTK) inhibitors are a new option to treat patients with WM. Zanubrutinib is a next-generation covalent BTK inhibitor designed to have fewer off-target effects than previous BTK inhibitors. This review summarizes the pharmacokinetic and pharmacodynamic properties of zanubrutinib as well as safety and efficacy findings. Then, it explores the health economic and outcomes research associated with the costs of treating patients with WM and the reasons why zanubrutinib may be a more cost-effective treatment option compared with ibrutinib, a first-generation BTK inhibitor. Future directions for the treatment of WM focus on the use of zanubrutinib in combination therapy. Combinations based on effective ibrutinib or acalabrutinib treatments may be effectively applied with zanubrutinib given the similar mechanism of action for these BTK inhibitors. Combination therapies could also help prevent the development of disease resistance, minimize toxicity, and support treatment regimens of finite duration.
摘要：
Waldenström巨球蛋白血症（WM）是一种罕见的非霍奇金B细胞淋巴瘤，临床表现可变，可通过引起贫血影响患者的生活质量。周围神经病变,血清高黏度,髓外疾病，和其他症状。WM患者有几种安全有效的治疗方案，和治疗的选择应该以个性化的方式考虑患者的症状，合并症,和基因组概况。布鲁顿酪氨酸激酶（BTK）抑制剂是治疗WM患者的新选择。Zanubrutinib是一种下一代共价BTK抑制剂，旨在比以前的BTK抑制剂具有更少的脱靶效应。这篇综述总结了扎努布替尼的药代动力学和药效学特性以及安全性和疗效发现。然后，它探讨了与治疗WM患者的成本相关的健康经济和结果研究，以及与伊布替尼相比，扎努布替尼可能是更具成本效益的治疗选择的原因，第一代BTK抑制剂。未来治疗WM的方向集中在联合治疗中扎努鲁替尼的使用。考虑到这些BTK抑制剂的类似作用机制，基于有效的依鲁替尼或阿卡拉布替尼治疗的组合可以与扎努鲁替尼有效应用。联合疗法还可以帮助防止疾病抵抗力的发展，尽量减少毒性，并支持有限持续时间的治疗方案。
