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慢性粒细胞白血病中酪氨酸激酶抑制剂的不良事件及剂量调整

Adverse events and dose modifications of tyrosine kinase inhibitors in chronic myelogenous leukemia.

作者信息

Yoshifuji Kota, Sasaki Koji

机构信息

Department of Hematology, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.

出版信息

Front Oncol. 2022 Oct 6;12:1021662. doi: 10.3389/fonc.2022.1021662. eCollection 2022.

Abstract

The prognosis of chronic myelogenous leukemia (CML-CP) in chronic phase has improved dramatically since the introduction of imatinib. In addition to imatinib, second- and third-generation tyrosine kinase inhibitors (TKIs) and a novel allosteric inhibitor, asciminib, are now available. During long-term TKI therapy, the optimal selection of TKI therapy for individual patients requires the understanding of specific patterns of toxicity profile to minimize chronic toxicity and the risk of adverse events, including pulmonary arterial hypertension, pleural effusion, and cardiovascular events. Given the high efficacy of TKI therapy, dose modifications of TKI therapy reduce the risk of toxicities and improves quality of life during therapy. In this review article, we summarize the characteristics and adverse event profile of each TKI and dose modifications in patients with CML-CP and discuss future perspectives in the treatment of CML-CP.

摘要

自伊马替尼问世以来,慢性期慢性髓性白血病(CML-CP)的预后有了显著改善。除伊马替尼外,第二代和第三代酪氨酸激酶抑制剂(TKIs)以及一种新型变构抑制剂阿塞西尼布现已可用。在长期TKI治疗期间,为个体患者优化选择TKI治疗需要了解特定的毒性特征模式,以尽量减少慢性毒性以及不良事件的风险,包括肺动脉高压、胸腔积液和心血管事件。鉴于TKI治疗的高效性,调整TKI治疗剂量可降低毒性风险并改善治疗期间的生活质量。在这篇综述文章中,我们总结了CML-CP患者中每种TKI的特点和不良事件概况以及剂量调整,并讨论了CML-CP治疗的未来前景。

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