Division of Hematology and Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA.
Target Oncol. 2011 Dec;6(4):203-15. doi: 10.1007/s11523-011-0202-9. Epub 2011 Nov 30.
Small molecule tyrosine kinase inhibitors (TKIs) are potent anti-cancer targeted therapies. TKIs are considered safe and efficacious therapeutic modalities, and are generally tolerated well. However, they are associated with certain side effects including hematologic toxicities such as anemia, macrocytosis, neutropenia, thrombocytopenia, hemolytic anemia, bone marrow aplasia and necrosis. Thrombotic microangiopathy, arterial thromboembolism and splenic infarction can also occur following treatment with TKIs. Cytopenias are the most common adverse effects associated with these agents, and other hematologic toxicities are not frequent. It is essential for clinicians to monitor patients closely, and recognize those side effects as early as possible, in order to improve efficacy of small molecule TKIs and optimize outcomes. This article summarizes hematologic toxicities associated with the commonly used small molecule TKIs. It also provides practical strategies for the management of these toxicities.
小分子酪氨酸激酶抑制剂（TKI）是有效的抗肿瘤靶向治疗药物。TKI 被认为是安全有效的治疗方法，通常耐受性良好。然而，它们与某些副作用相关，包括血液学毒性，如贫血、巨红细胞症、中性粒细胞减少症、血小板减少症、溶血性贫血、骨髓再生不良和坏死。TKI 治疗后还可能发生血栓性微血管病、动脉血栓栓塞和脾梗死。血细胞减少是与这些药物相关的最常见的不良反应，其他血液学毒性并不常见。临床医生必须密切监测患者，并尽早识别这些副作用，以提高小分子 TKI 的疗效并优化治疗结果。本文总结了常用小分子 TKI 相关的血液学毒性，并提供了这些毒性的管理实用策略。
