Dana-Farber Cancer Institute, 450 Brookline Avenue Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA.
J Geriatr Oncol. 2018 Jul;9(4):291-295. doi: 10.1016/j.jgo.2018.01.008. Epub 2018 Feb 18.
Chronic myeloid leukemia (CML), a myeloproliferative neoplasm defined by the t(9;22)(q34;q11) chromosomal translocation, primarily affects older adults. Historically, effective treatment options were not available for older CML patients ineligible for curative allogeneic stem cell transplant, and the disease was therefore usually fatal within several years of diagnosis. The development of tyrosine kinase inhibitors (TKIs) that effectively target the constitutively active mutant tyrosine kinase in CML has dramatically improved outcomes for all patients with CML, including older patients. While older patients were underrepresented in prospective trials, TKI therapy can be successfully administered to older adults with CML with excellent efficacy and proven tolerability. TKI selection and monitoring for adverse events should be tailored based on co-morbidities. As with younger patients, life expectancy of older adults with CML now approaches that of age-matched controls. Here we review guidelines for management of older adults with CML.
慢性髓性白血病（CML）是一种由 t（9；22）（q34；q11）染色体易位定义的骨髓增殖性肿瘤，主要影响老年人。在历史上，对于不适合根治性异基因干细胞移植的老年 CML 患者，没有有效的治疗选择，因此该疾病通常在诊断后几年内致命。针对 CML 中持续激活的突变酪氨酸激酶的酪氨酸激酶抑制剂（TKI）的开发，极大地改善了所有 CML 患者的预后，包括老年患者。尽管前瞻性试验中老年人的代表性不足，但 TKI 治疗可以成功地用于老年 CML 患者，疗效极佳且耐受性已得到证实。应根据合并症来选择 TKI 并监测不良反应。与年轻患者一样，现在老年 CML 患者的预期寿命接近年龄匹配的对照者。在这里，我们回顾了管理老年 CML 患者的指南。
