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真实环境中使用 ponatinib 治疗的慢性髓性白血病患者的管理:来自意大利药品管理局(AIFA)监测登记处的回顾性分析。

Management of chronic myeloid leukaemia patients treated with ponatinib in a real-life setting: A retrospective analysis from the monitoring registries of the Italian Medicines Agency (AIFA).

机构信息

Department of Translational and Precision Medicine, Az. Policlinico Umberto I-Sapienza University, Rome, Italy.

Italian Medicines Agency, Rome, Italy.

出版信息

Br J Haematol. 2022 Sep;198(6):965-973. doi: 10.1111/bjh.18359. Epub 2022 Jul 29.

Abstract

Real-world data on daily practice management, treatment modifications and outcome of a large cohort of chronic myeloid leukaemia (CML) patients treated with ponatinib was performed through monitoring Registries of the Italian Medicines Agency (AIFA). Overall, 666 CML subjects were included in the ponatinib registry from February 2015 to December 2020 and were eligible for analysis: 515 in chronic phase (CP), 50 in accelerated phase (AP) and 101 in blast crisis (BC). Median age at baseline was 58.7 years with a predominance of male subjects (57.1%). The median time from diagnosis to start of ponatinib was 2.35 years: 259 (38.9%) subjects had received two previous lines of treatment, 260 (39.0%) three lines and 147 (22.1%) four or more lines. A molecular response [from major molecular response (MMR) to a score of ≤0.01% on the international reporting scale (IS)] was reported for 59% of patients out of 593 patients analysed. With a median follow-up of 14.4 months, 136 subjects (20.4%) required at least one dose reduction due to adverse events (AEs), whereas 309 patients (46.4%) required dose reduction in the absence of any evidence of side effects. Treatment discontinuation occurred in 261 patients (39%). This real-life analysis shows that dose reductions were made primarily as a precaution rather than due to the occurrence of adverse reactions.

摘要

通过监测意大利药品管理局(AIFA)的登记处,获得了大量接受普纳替尼治疗的慢性髓性白血病(CML)患者的日常实践管理、治疗调整和结局的真实世界数据。总体而言,从 2015 年 2 月到 2020 年 12 月,共有 666 名 CML 患者纳入普纳替尼登记处,符合分析条件:515 名处于慢性期(CP),50 名处于加速期(AP),101 名处于急变期(BC)。基线时的中位年龄为 58.7 岁,男性居多(57.1%)。从诊断到开始接受普纳替尼治疗的中位时间为 2.35 年:259 名(38.9%)患者接受了两种以上的治疗方案,260 名(39.0%)患者接受了三种以上的治疗方案,147 名(22.1%)患者接受了四种或更多种治疗方案。在分析的 593 名患者中,有 59%的患者报告了分子学反应[从主要分子学反应(MMR)到国际报告标准(IS)的≤0.01%评分]。在 14.4 个月的中位随访中,由于不良反应(AE),136 名患者(20.4%)需要至少减少一次剂量,而 309 名患者(46.4%)在没有任何副作用证据的情况下需要减少剂量。261 名患者(39%)停止了治疗。这项真实世界的分析表明,剂量减少主要是作为预防措施,而不是由于不良反应的发生。

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