Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Expert Opin Drug Saf. 2024 Apr;23(4):411-423. doi: 10.1080/14740338.2024.2331190. Epub 2024 Apr 1.
Since the introduction of first tyrosine kinase inhibitor (TKI) imatinib, the treatment of chronic myeloid leukemia (CML) has reached excellent survival expectancies. Long survival rates bring about issues regarding TKI safety.
The aim of this review is to compare the side effects of current TKIs both in the first and later lines and outline a safety andprofile of CML treatment. Seminal studies on TKIs and other newer drugs and extended follow-up of these studies; real-life data of each drug were usedduring the course of this. PubMed was used as a search database and onlyarticles in English were included.
With longer follow-up CML patients, resistant slowgrade adverse events seem to be the major obstacle in the way of treatmentefficacy. If efficacy is the priority, vigorous treatment of side effect and administration of full dose TKI are reasonable. But when treatment goals are reached, dose modifications or alternative treatment regimens may be acceptedpossible. More studies are needed on dose modification protocols and potential benefits and safety of treatment-free remission.
自第一代酪氨酸激酶抑制剂（TKI）伊马替尼问世以来，慢性髓性白血病（CML）的治疗已达到了极佳的生存预期。较长的生存率带来了 TKI 安全性方面的问题。
本综述旨在比较当前 TKI 在一线和二线治疗中的副作用，并概述 CML 治疗的安全性和概况。我们使用了 TKI 和其他新型药物的开创性研究以及对这些研究的延长随访数据；在研究过程中使用了每种药物的真实数据。我们使用 PubMed 作为搜索数据库，仅收录英文文章。
随着对 CML 患者的随访时间延长，耐药性、缓慢进展的不良事件似乎是治疗效果的主要障碍。如果疗效是首要考虑因素，那么积极治疗副作用并给予 TKI 全剂量是合理的。但是，当治疗目标达到时，可能会接受剂量调整或替代治疗方案。需要更多关于剂量调整方案以及无治疗缓解的潜在益处和安全性的研究。
