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合并症对慢性髓性白血病患者酪氨酸激酶抑制剂选择的影响。

The effect of comorbidities on the choice of tyrosine kinase inhibitors in patients with chronic myeloid leukemia.

作者信息

Saydam Guray, Ali Ridvan, Demir Ahmet Muzaffer, Eskazan Ahmet Emre, Guvenc Birol, Haznedaroglu Ibrahim Celalettin, Ozcan Mehmet Ali, Salim Ozan, Sonmez Mehmet, Tuglular Ayse Tulin, Turgut Mehmet, Unal Ali, Aver Birkan, Bozkurt Sirac, Ozdengulsun Begum, Ilhan Osman

机构信息

Department of Internal Diseases, Division of Hematology, Ege University Medical Faculty Hospital, İzmir, Turkey.

Department of Internal Diseases, Division of Hematology, Uludag University Medical Faculty Hospital, Bursa, Turkey.

出版信息

Int J Hematol Oncol. 2022 May 24;11(1):IJH38. doi: 10.2217/ijh-2021-0010. eCollection 2022 Mar.

Abstract

Tyrosine kinase inhibitors (TKIs) approved for chronic myeloid leukemia known to have similar efficacies but different safety profiles. Therefore, the choice of patient-specific treatments is driven by factors such as tolerability and adverse event profile of TKIs. This review article examines the most up-to-date data and provides practical recommendations for clinical approaches. Nilotinib and ponatinib should be avoided in patients with cardiovascular risk factors, dasatinib in patients with lung damage and bosutinib and nilotinib in patients with liver disease. Considering that certain comorbidities predispose some patients to developing severe adverse events when receiving TKIs, the first- and second-line treatment of chronic myeloid leukemia should be tailored to each patient's individual condition.

摘要

已批准用于慢性髓性白血病的酪氨酸激酶抑制剂(TKIs)具有相似的疗效,但安全性不同。因此,针对特定患者的治疗选择取决于诸如TKIs的耐受性和不良事件特征等因素。这篇综述文章研究了最新数据,并为临床方法提供了实用建议。有心血管危险因素的患者应避免使用尼洛替尼和波纳替尼,有肺损伤的患者应避免使用达沙替尼,有肝病的患者应避免使用博舒替尼和尼洛替尼。鉴于某些合并症会使一些患者在接受TKIs时易发生严重不良事件,慢性髓性白血病的一线和二线治疗应根据每个患者的个体情况进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d670/9136639/9ab202147025/ijh-11-38-g1.jpg

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