McMaster University, Hamilton, Ontario, Canada.
Eur J Haematol. 2022 Aug;109(2):166-181. doi: 10.1111/ejh.13786. Epub 2022 May 24.
Effective treatments for hematologic malignancies include therapies that target tyrosine kinase (TK) signaling pathways. Tumor lysis syndrome (TLS) is an oncologic emergency that can occur due to rapid turnover following the initiation of treatments for hematologic malignancy. The incidence of TLS is under-reported and it is unclear as to whether TK inhibitors (TKIs) are associated with TLS.
To conduct a systematic review to determine the incidence of TLS with TKIs.
A search was performed using EMBASE, MEDLINE, and Web of Science electronic databases, as well as a manual search of the American Society of Hematology and American Society of Clinical Oncology abstract databases. Keywords included: "tumor lysis syndrome," "tyrosine kinase inhibitors," "lymphoma," and "leukemia."
We identified a total of 57 publications that commented on the incidence of TLS with TKIs for hematologic malignancy. Thirty-nine of those publications reported TLS as an adverse event. TLS was described as an adverse event among essentially all the subclasses of TKIs that are used to manage hematologic malignancies.
The overall number of articles commenting on TLS as an adverse event is sparse and there needs to be more transparency regarding the incidence of TLS when employing newer targeted therapies. Physicians should consider the risk of TLS on an individual basis and the added risk of TLS when using TKIs to treat hematologic malignancy.
有效的血液系统恶性肿瘤治疗方法包括靶向酪氨酸激酶(TK)信号通路的治疗方法。肿瘤溶解综合征(TLS)是一种肿瘤急症,可能由于血液系统恶性肿瘤治疗开始后快速代谢而发生。TLS 的发病率报道不足,也不清楚 TK 抑制剂(TKIs)是否与 TLS 相关。
进行系统评价以确定 TKI 治疗血液系统恶性肿瘤时 TLS 的发生率。
使用 EMBASE、MEDLINE 和 Web of Science 电子数据库进行搜索,并手动搜索美国血液学会和美国临床肿瘤学会摘要数据库。关键词包括:“肿瘤溶解综合征”、“酪氨酸激酶抑制剂”、“淋巴瘤”和“白血病”。
我们共确定了 57 篇评论 TKI 治疗血液系统恶性肿瘤时 TLS 发生率的出版物。其中 39 篇出版物将 TLS 描述为不良事件。TLS 被描述为用于治疗血液系统恶性肿瘤的所有 TKIs 亚类中几乎都会发生的不良事件。
评论 TLS 作为不良事件的文章总数很少,在使用新的靶向治疗时,需要更透明地了解 TLS 的发病率。医生应根据个体情况考虑 TLS 的风险,以及使用 TKIs 治疗血液系统恶性肿瘤时 TLS 的附加风险。