Martino Suella, Daguindau Etienne, Ferrand Christophe, Bamoulid Jamal, Hayette Sandrine, Nicolini F-E, Capellier G, Deconinck Eric, Larosa Fabrice
CHU Besançon, Service d'Hématologie, Besançon, France.
CHU Besançon, Service d'Hématologie, Besançon, France ; Université de Franche-Comté, IFR 133, Besançon, France.
Leuk Res Rep. 2013 Mar 19;2(1):29-31. doi: 10.1016/j.lrr.2013.02.003. eCollection 2013.
Second-generation tyrosine kinase inhibitors (TKI2) often induce molecular remission, and prolonged survival with a better tolerance in imatinib-resistant chronic myelogenous leukaemia (CML) patients. We report the case of a CML in first chronic phase who was diagnosed in August 2003 in a young 24 year-old Caucasian woman. Our patient received first imatinib and then dasatinib and nilotinib. Imatinib was well tolerated and she developed TTP/HUS on dasatinib without documented evolution of CML and finally obtained MR5.0 with nilotinib and without any side effect. This case also illustrates the absence of cross-resistance and side-effects between the different TKIs and the feasibility of kidney transplantation associated with a nilotinib treatment of CML allowing a continuing MR5.0 and no further side effects.
第二代酪氨酸激酶抑制剂（TKI2）常可诱导分子缓解，使伊马替尼耐药的慢性髓性白血病（CML）患者生存期延长且耐受性更好。我们报告一例2003年8月诊断为慢性期CML的年轻24岁白种女性病例。我们的患者首先接受伊马替尼治疗，之后使用达沙替尼和尼洛替尼。伊马替尼耐受性良好，她在使用达沙替尼时发生血栓性血小板减少性紫癜/溶血尿毒综合征（TTP/HUS），CML无进展记录，最终使用尼洛替尼获得了MR5.0且无任何副作用。该病例还说明了不同TKI之间不存在交叉耐药和副作用，以及与尼洛替尼治疗CML相关的肾移植的可行性，可维持MR5.0且无进一步副作用。
