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依维莫司对与结节性硬化症相关的肾血管平滑肌脂肪瘤患者血液学参数的影响。

The impact of everolimus on hematologic parameters in patients with renal angiomyolipoma associated with tuberous sclerosis complex.

作者信息

Qiu Dongxu, Wang Wenda, Zhao Yang, Wang Zhan, Wang Xu, Liao Zhangcheng, Zhang Yushi

机构信息

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan Wangfujing, Beijing, 100730, People's Republic of China.

Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, BC, V6H 3Z6, Canada.

出版信息

Discov Oncol. 2024 Sep 12;15(1):438. doi: 10.1007/s12672-024-01329-x.

Abstract

BACKGROUND

Everolimus is an effective treatment for renal angiomyolipoma associated with TSC (TSC-RAML). However, its impact on hematologic parameters in TSC-RAML patients remains unclear.

METHODS

Hematologic data were collected from TSC-RAML patients undergoing everolimus treatment in two registered clinical trials. Dynamic changes in hematologic parameters during treatment were analyzed. Additionally, we also explored variations in hematologic impact based on gender and age within the patient population.

RESULT

A total of 55 patients from the two clinical trials are included in this analysis. Hemoglobin, white blood cells (WBC), lymphocytes, neutrophils, and platelet showed significant decreases during everolimus treatment (P < 0.05). However, the decline in hemoglobin, WBC, and neutrophils attenuated by the 12th month (P ≥ 0.05). Aspartate transaminase (AST), Alanine transferase (ALT), total cholesterol (TC), and triglyceride (TG) increased significantly during everolimus treatment (P < 0.05), and these increases persisted throughout the year-long treatment. Hemoglobin decreased significantly more in male patients (- 15 vs - 6, P = 0.010), and AST showed a more significant increase in males (7.0 vs 3.0, P = 0.041). Platelet counts decreased significantly more in younger patients (≤ 30 years old) compared to older patients (- 50 vs - 14, P = 0.020).

CONCLUSION

Everolimus administration in TSC-RAML patients may increase hematologic risks, with male and younger patients potentially exhibiting greater susceptibility to these effects.

摘要

背景

依维莫司是治疗与结节性硬化症相关的肾血管平滑肌脂肪瘤(TSC-RAML)的有效药物。然而,其对TSC-RAML患者血液学参数的影响尚不清楚。

方法

从两项注册临床试验中接受依维莫司治疗的TSC-RAML患者收集血液学数据。分析治疗期间血液学参数的动态变化。此外,我们还探讨了患者群体中基于性别和年龄的血液学影响差异。

结果

两项临床试验中的55例患者纳入本分析。依维莫司治疗期间血红蛋白、白细胞(WBC)、淋巴细胞、中性粒细胞和血小板均显著下降(P<0.05)。然而,到第12个月时,血红蛋白、WBC和中性粒细胞的下降有所缓解(P≥0.05)。依维莫司治疗期间天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆固醇(TC)和甘油三酯(TG)显著升高(P<0.05),且这些升高在长达一年的治疗中持续存在。男性患者血红蛋白下降更显著(-15 vs -6,P=0.010),AST在男性中升高更显著(7.0 vs 3.0,P=0.041)。与老年患者相比,年轻患者(≤30岁)血小板计数下降更显著(-50 vs -14,P=0.020)。

结论

TSC-RAML患者使用依维莫司可能增加血液学风险,男性和年轻患者可能对这些影响更敏感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff3/11393373/6cefb58cf220/12672_2024_1329_Fig1_HTML.jpg

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