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世界卫生组织2016年慢性髓性白血病和酪氨酸激酶抑制剂的定义。

WHO 2016 Definition of Chronic Myeloid Leukemia and Tyrosine Kinase Inhibitors.

作者信息

Haznedaroğlu İbrahim C., Kuzu Işınsu, İlhan Osman

机构信息

Hacettepe University Faculty of Medicine, Department of Hematology, Ankara, Turkey

Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey

出版信息

Turk J Haematol. 2020 Feb 20;37(1):42-47. doi: 10.4274/tjh.galenos.2019.2019.0241. Epub 2019 Oct 15.

Abstract

Philadelphia (Ph*)/BCR-ABL1-positive chronic myeloid leukemia (CML) is considered as a chronic life-long disease, which could be manageable with tyrosine kinase inhibitor (TKI) drugs. The aim of TKI drug treatment is to provide age- and sex-matched duration of life in a given patient with CML. Personalized CML treatment with TKI drugs is the key strategy. Individual treatment approach includes the harmonization of CML disease characteristics, clinical experience, and best available clinical evidence. Specific CML disease characteristics in a given patient include; CML disease risk, comorbidities, molecular profile, compliance, lifestyle, and drug off-target risk profile. CML research evidence includes; randomized clinical trials indicating the data on the efficacy, safety, tolerability, toxicity, possible long-term adverse events, and pharmacoeconomy of TKIs. Clinical and physician experience includes TKI availability, TKI reimbursability, drug experience, adherence, and BCR-ABL1 monitorization facilities. The key decision of choosing a TKI of choosing TKIs for CML should be made via the consideration of these variables. The aim of this paper is to outline the latest 2016 World Health Organization definition of CML and its proper management with TKI-class drugs.

摘要

费城染色体(Ph*)/BCR-ABL1阳性慢性髓性白血病(CML)被认为是一种终身慢性疾病,可用酪氨酸激酶抑制剂(TKI)药物进行控制。TKI药物治疗的目的是为特定的CML患者提供与年龄和性别相匹配的生存时长。使用TKI药物进行CML个性化治疗是关键策略。个体化治疗方法包括协调CML疾病特征、临床经验和最佳可得临床证据。特定CML患者的疾病特征包括:CML疾病风险、合并症、分子谱、依从性、生活方式和药物脱靶风险谱。CML研究证据包括:随机临床试验,表明TKI的疗效、安全性、耐受性、毒性、可能的长期不良事件和药物经济学数据。临床和医生经验包括TKI的可获得性、TKI的可报销性、用药经验、依从性和BCR-ABL1监测设施。选择CML的TKI的关键决策应通过考虑这些变量来做出。本文的目的是概述2016年世界卫生组织对CML的最新定义及其使用TKI类药物的合理管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac3c/7057757/c781a05124ad/TJH-37-42-g1.jpg

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