Umezawa Yoshihiro, Sasaki Koji
Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 428, Houston, TX, 77030, USA.
Int J Hematol. 2023 Jan;117(1):24-29. doi: 10.1007/s12185-022-03431-8. Epub 2022 Sep 10.
The therapeutic outcomes of chronic myeloid leukemia (CML) have improved dramatically since tyrosine kinase inhibitors (TKIs) became available in clinical practice. Life expectancy of patients with CML is now close to that of the general population. Patients with CML who achieve sustained deep molecular response may discontinue TKI therapy. However, most patients still require TKI therapy for long periods without sustained deep molecular response. Given the awareness of increased incidence of arterial occlusive events in patients on TKI therapy, the optimal TKI selection should be based on age, comorbidities, risk classification, and goals of treatment. Dose optimization of TKI therapy reduces the incidence of adverse events while maintaining efficacy in CML.
自从酪氨酸激酶抑制剂（TKIs）应用于临床实践以来，慢性髓性白血病（CML）的治疗效果有了显著改善。CML患者的预期寿命现已接近普通人群。实现持续深度分子反应的CML患者可能会停止TKI治疗。然而，大多数患者在没有持续深度分子反应的情况下仍需要长期接受TKI治疗。鉴于意识到接受TKI治疗的患者动脉闭塞事件发生率增加，最佳的TKI选择应基于年龄、合并症、风险分类和治疗目标。TKI治疗的剂量优化可降低不良事件的发生率，同时维持CML治疗的疗效。
