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酪氨酸激酶抑制剂相关的慢性髓性白血病血管毒性

Tyrosine kinase inhibitor associated vascular toxicity in chronic myeloid leukemia.

作者信息

Pasvolsky Oren, Leader Avi, Iakobishvili Zaza, Wasserstrum Yishay, Kornowski Ran, Raanani Pia

机构信息

Hematology Institute, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, 39 Jabotinsky Street, Petah Tikva, 49100, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Cardiooncology. 2015 Dec 4;1(1):5. doi: 10.1186/s40959-015-0008-5.

Abstract

Tyrosine kinase inhibitors (TKIs) have revolutionized the management and outcomes of chronic myeloid leukemia (CML) patients. Improved disease control and prolonged life expectancy now mandate focus on improving TKIs' safety profile. Recently, vascular adverse events (VAEs) have emerged as a serious consequence of some of the newer TKIs. In this review, we describe the clinical spectrum of TKI-associated VAE, and examine the unique vascular safety profile of the main TKIs currently used in the treatment of CML: imatinib, nilotinib, dasatinib, bosutinib and ponatinib. The issue of TKI-related platelet dysfunction is discussed as well. We describe the contemporary research findings regarding the possible pathogenesis of the VAE. Finally, the different aspects of TKI-associated VAE management are addressed, including prevention methods, monitoring strategies and treatment options.

摘要

酪氨酸激酶抑制剂(TKIs)彻底改变了慢性髓性白血病(CML)患者的治疗管理和治疗结果。如今,疾病控制的改善和预期寿命的延长使得人们必须将重点放在提高TKIs的安全性上。最近,血管不良事件(VAEs)已成为一些新型TKIs的严重后果。在本综述中,我们描述了TKI相关VAEs的临床谱,并研究了目前用于治疗CML的主要TKIs(伊马替尼、尼洛替尼、达沙替尼、博舒替尼和波纳替尼)独特的血管安全性。还讨论了TKI相关血小板功能障碍的问题。我们描述了关于VAEs可能发病机制的当代研究结果。最后,阐述了TKI相关VAEs管理的不同方面,包括预防方法、监测策略和治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d0/7837152/48f9b48cc5f5/40959_2015_8_Fig1_HTML.jpg

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