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采用布鲁顿酪氨酸激酶抑制剂治疗慢性淋巴细胞白血病:门诊肿瘤护士的作用。

Treating CLL with Bruton Tyrosine Kinase Inhibitors: The Role of the Outpatient Oncology Nurse.

机构信息

Alberta Blood and Marrow Transplant Clinic, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alb, Canada.

Associate Professor, Division of Hematology & Hematological Malignancies, University of Calgary, Calgary, Alb, Canada.

出版信息

Semin Oncol Nurs. 2021 Aug;37(4):151177. doi: 10.1016/j.soncn.2021.151177. Epub 2021 Jul 16.

Abstract

OBJECTIVES

To summarize the role of Bruton tyrosine kinase (BTK) inhibitors in the management of chronic lymphocytic leukemia with a focus on the nursing role in relation to patients with chronic lymphocytic leukemia being treated with BTK inhibitors.

DATA SOURCES

These include published articles (PubMed) and national and international guideline documents.

CONCLUSION

BTK inhibitors have revolutionized the therapy of chronic lymphocytic leukemia and have become the most frequently used therapy today. Despite the many advantages of BTK inhibitors, adverse events remain a leading cause of treatment discontinuation, particularly for the first-in-class BTK inhibitor. Second-generation BTK inhibitors appear to have a better tolerability profile but still require adverse event management given their prolonged duration of therapy. Awareness and management of side effects by the oncology care team is essential for ensuring both compliance and safety with ongoing treatment.

IMPLICATIONS FOR NURSING PRACTICE

Chronic lymphocytic leukemia is a chronic illness with a long-life expectancy. For the patients who require therapy, BTK inhibitor therapy is a frequently applied treatment with impressive efficacy. BTK inhibitors are continued indefinitely until disease progression or significant toxicity; therefore, the overall principles of careful assessment for side effects, diligent management for these, and individualized patient support provided by oncology nurses is vital in this patient population.

摘要

目的

总结布鲁顿酪氨酸激酶(BTK)抑制剂在慢性淋巴细胞白血病治疗中的作用,重点介绍与接受 BTK 抑制剂治疗的慢性淋巴细胞白血病患者相关的护理作用。

资料来源

包括已发表的文章(PubMed)和国家及国际指南文件。

结论

BTK 抑制剂彻底改变了慢性淋巴细胞白血病的治疗方法,现已成为当今最常用的治疗方法。尽管 BTK 抑制剂有许多优点,但不良反应仍是导致治疗中断的主要原因,尤其是对于首类 BTK 抑制剂。第二代 BTK 抑制剂似乎具有更好的耐受性,但由于其治疗持续时间较长,仍需要进行不良反应管理。肿瘤护理团队对不良反应的认识和管理对于确保治疗的依从性和安全性至关重要。

对护理实践的意义

慢性淋巴细胞白血病是一种预期寿命长的慢性疾病。对于需要治疗的患者来说,BTK 抑制剂治疗是一种经常应用的、疗效显著的治疗方法。BTK 抑制剂会持续使用,直至疾病进展或出现严重毒性;因此,肿瘤护士对不良反应进行仔细评估、对这些不良反应进行认真管理以及为患者提供个体化支持的总体原则,对于这一患者群体至关重要。

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