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鲁索替尼治疗真性红细胞增多症后骨髓纤维化患者后发生肿瘤溶解综合征

Tumor Lysis Syndrome after the Administration of Ruxolitinib in a Patient with Post-polycythemia Vera Myelofibrosis.

作者信息

Koshiishi Megumi, Sueki Yuki, Kawashima Ichiro, Nakajima Kei, Mitsumori Toru, Kirito Keita

机构信息

Department of Hematology and Oncology, University of Yamanashi, Japan.

出版信息

Intern Med. 2017 Sep 1;56(17):2335-2338. doi: 10.2169/internalmedicine.8706-16. Epub 2017 Aug 10.

DOI:10.2169/internalmedicine.8706-16
PMID:28794380
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5635310/
Abstract

The development of tumor lysis syndrome (TLS) in association with treatment for myeloproliferative neoplasms (MPNs) is relatively rare. We herein present the case of a post-polycythemia vera (PV) myelofibrosis patient with massive splenomegaly who developed laboratory TLS after treatment with ruxolitinib, a potent JAK1/JAK2 inhibitor. She also exhibited a rapid reduction of spleen volume. Our present case suggests the potential risk of TLS development after ruxolitinib treatment, particularly in patients with massive splenomegaly.

摘要

与骨髓增殖性肿瘤（MPN）治疗相关的肿瘤溶解综合征（TLS）的发生相对罕见。我们在此报告一例真性红细胞增多症（PV）后骨髓纤维化患者，该患者脾肿大明显，在接受强效JAK1/JAK2抑制剂鲁索替尼治疗后出现实验室检查提示的TLS。她的脾脏体积也迅速缩小。我们目前的病例提示鲁索替尼治疗后有发生TLS的潜在风险，尤其是在脾肿大明显的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/11ff85b0e59c/1349-7235-56-2335-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/0b848e7bbe00/1349-7235-56-2335-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/4893153ce486/1349-7235-56-2335-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/11ff85b0e59c/1349-7235-56-2335-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/0b848e7bbe00/1349-7235-56-2335-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/4893153ce486/1349-7235-56-2335-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/5635310/11ff85b0e59c/1349-7235-56-2335-g003.jpg

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本文引用的文献

1
Assessing the safety and efficacy of ruxolitinib in a multicenter, open-label study in Japanese patients with myelofibrosis.在一项针对日本骨髓纤维化患者的多中心、开放标签研究中评估鲁索替尼的安全性和有效性。
Int J Hematol. 2017 Mar;105(3):309-317. doi: 10.1007/s12185-016-2130-z. Epub 2016 Nov 10.
2
Ruxolitinib dose management as a key to long-term treatment success.芦可替尼剂量管理是长期治疗成功的关键。
Int J Hematol. 2016 Oct;104(4):420-9. doi: 10.1007/s12185-016-2084-1. Epub 2016 Aug 27.
3
Ruxolitinib versus standard therapy for the treatment of polycythemia vera.
芦可替尼与标准疗法治疗真性红细胞增多症的对比
N Engl J Med. 2015 Jan 29;372(5):426-35. doi: 10.1056/NEJMoa1409002.
4
Ruxolitinib is a potent immunosuppressive compound: is it time for anti-infective prophylaxis?芦可替尼是一种强效免疫抑制化合物：是时候进行抗感染预防了吗？
Blood. 2013 Nov 28;122(23):3843-4. doi: 10.1182/blood-2013-10-531103.
5
Ruxolitinib withdrawal syndrome leading to tumor lysis.导致肿瘤溶解的鲁索替尼撤药综合征。
J Clin Oncol. 2013 Oct 10;31(29):e430-2. doi: 10.1200/JCO.2012.47.6473. Epub 2013 Jun 10.
6
Tumor lysis syndrome soon after treatment with hydroxyurea followed by nilotinib in two patients with chronic-phase chronic myelogenous leukemia.两名慢性期慢性髓性白血病患者在接受羟基脲治疗后紧接着使用尼罗替尼治疗后发生肿瘤溶解综合征。
Int J Hematol. 2013 Aug;98(2):243-6. doi: 10.1007/s12185-013-1356-2. Epub 2013 May 7.
7
A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis.芦可替尼治疗骨髓纤维化的双盲、安慰剂对照试验。
N Engl J Med. 2012 Mar 1;366(9):799-807. doi: 10.1056/NEJMoa1110557.
8
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