Acalabrutinib Maleate and Bortezomib for Patients With HLA Antibodies

Inclusion criteria

• Patients with hematological malignancies and platelet transfusion refractoriness (24-hour CCI < 4.5×10⁹/L or PPR < 20%), and with the highest MFI of HLA antibodies > 8000 ;
• Age 18-65 years, both male and female;
• ECOG performance status 0-3;
• Expected survival > 6 months;
• Patients must be able to understand and be willing to participate in this study, and sign an informed consent form.

Exclusion criteria

• Hypersensitivity to acalabrutinib, bortezomib, or excipients;
• Major organ bleeding (central nervous system, lung, intestines) or grade ≥3 bleeding;
• Hypersplenism;
• Concurrent use of drugs that may cause excessive platelet consumption (amphotericin B, vancomycin, ATG, interferon, etc.);
• Disseminated intravascular coagulation, microangiopathic hemolytic anemia;
• Underlying diseases of vital organs: such as malignant arrhythmia, myocardial infarction, chronic cardiac insufficiency, decompensated liver insufficiency, renal insufficiency, severe coagulation abnormalities, etc.; persistent fever (>38.0°C) for more than 3 days; clinically uncontrolled active infection (including bacterial, fungal, or viral infections), but patients under effective drug therapy are not excluded;
• Concurrent other progressive malignancies;
• Patients with cardiac insufficiency: ejection fraction (EF) <30%, NYHA class ≥III cardiac insufficiency;
• Pregnant or lactating women;
• Expected survival <60 days;
• Currently participating in other clinical drug trials.