在一所综合性大学医院评估酪氨酸激酶抑制剂在慢性髓性白血病中的使用、疗效和安全性。
Evaluation of the use, effectiveness and safety of tyrosine kinase inhibitors in chronic myelogenous leukaemia in a general university hospital.
机构信息
Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
出版信息
Eur J Hosp Pharm. 2020 Sep;27(5):299-301. doi: 10.1136/ejhpharm-2017-001378. Epub 2018 Feb 14.
OBJECTIVES
To evaluate the use, effectiveness and safety of tyrosine kinase inhibitors (TKIs) for chronic myelogenous leukaemia (CML) in clinical practice.
METHODS
A retrospective longitudinal study of patients with CML who received TKIs for at least 6 months was performed. Endpoints to evaluate effectiveness were haematological, cytogenetic and molecular responses. Safety was assessed according to the occurrence of adverse events.
RESULTS
Sixty-two patients were included. All received imatinib as the initial TKI; 8% switched to nilotinib due to lack of major molecular response (MMR) to imatinib and 3% switched to dasatinib because of progression to blast crisis or lack of MMR. At the end of the study all patients had achieved at least a complete cytogenetic response. With regard to safety, in 11 patients the dose of imatinib was decreased and four patients switched to a second-generation TKI due to imatinib toxicity.
CONCLUSIONS
Considering the good responses of most patients and its better known safety profile, imatinib should remain a good option for first-line treatment of CML.
目的
评估酪氨酸激酶抑制剂（TKI）在慢性髓性白血病（CML）临床实践中的应用、疗效和安全性。
方法
对至少接受 TKI 治疗 6 个月的 CML 患者进行回顾性纵向研究。评估疗效的终点包括血液学、细胞遗传学和分子学反应。根据不良事件的发生情况评估安全性。
结果
共纳入 62 例患者。所有患者均初始接受伊马替尼作为 TKI；8%的患者因对伊马替尼缺乏主要分子反应（MMR）而改用尼罗替尼，3%的患者因进展为急变期或缺乏 MMR 而改用达沙替尼。研究结束时，所有患者均至少达到完全细胞遗传学反应。关于安全性，11 例患者因伊马替尼毒性而减少了伊马替尼的剂量，4 例患者改用第二代 TKI。
结论
鉴于大多数患者的良好反应及其更为人所知的安全性特征，伊马替尼仍应作为 CML 一线治疗的一个较好选择。
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