García-Gutiérrez Valentín, Hernández-Boluda Juan Carlos Carlos
Hematology Service, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain.
Hematology Service, Hospital Clínico Universitario INCLIVA, 46010 Valencia, Spain.
J Clin Med. 2020 Jul 15;9(7):2251. doi: 10.3390/jcm9072251.
Despite the excellent overall survival (OS) of patients with chronic myeloid leukemia (CML), a significant proportion will not achieve optimal response to imatinib or second-generation tyrosine kinase inhibitors (2GTKI). For patients with inadequate response to 2GTKIs, alternative 2GTKIs or ponatinib are widely available treatment options in daily clinical practice. Treatment decisions should be guided by correct identification of the cause of treatment failure and accurate distinction between resistant from intolerant or nonadherence patients. This review aims to provide practical advice on how to select the best treatment option in each clinical scenario.
尽管慢性髓性白血病(CML)患者的总体生存率(OS)良好,但仍有相当一部分患者对伊马替尼或第二代酪氨酸激酶抑制剂(2GTKI)无法达到最佳反应。对于对2GTKIs反应不足的患者,在日常临床实践中,替代的2GTKIs或泊那替尼是广泛可用的治疗选择。治疗决策应基于正确识别治疗失败的原因以及准确区分耐药患者与不耐受或不依从患者。本综述旨在就如何在每种临床情况下选择最佳治疗方案提供实用建议。