ダサチニブで治療された患者の肺動脈高血圧
David Montani1, Emmanuel Bergot, Sven Günther
1Univ. Paris-Sud, Faculté de Médecine, Le Kremlin-Bicêtre, France.
Circulation
|March 28, 2012
まとめ
ダサチニブは,慢性骨髄性白血病の患者において,重度のプレキャピラリ肺高血圧 (PH) を引き起こす可能性があります. ダサチニブを中止すると,しばしばPHが改善されますが,完全な回復は保証されません.
科学分野:
- 心臓病学 心臓病学
- 腫瘍学 腫瘍学
- 薬理学 薬理学とは
背景:
- 肺高血圧 (PH) は,慢性骨髄性白血病 (CML) 治療の既知の合併症である.
- ダサチニブなどのチロシンキナーゼ阻害剤 (TKI) は,CMLの治療に使用されます.
- ダサチニブで治療された患者で,プリカピラーPHの孤立した症例が報告されています.
研究 の 目的:
- ダサチニブに関連したPHのインシデント症例を記述する.
- これらの患者の臨床的プレゼンテーション,治療,およびアウトカムを分析する.
- ダサチニブに暴露された患者におけるPHの発生率を推定する.
主な方法:
- ダサチニブで治療された患者で診断されたPHの9件のインシデント症例の遡及的分析.
- 2006年11月から2010年9月までの間にフランスのPH登録から収集されたデータ.
- ダサチニブを中止する前と後の臨床,機能,および血液動力学的パラメータの評価.
主要な成果:
- 全9人の患者は,中等度から重度までの頭前毛細血管PHを示した.
- ダサチニブを中止してから4カ月以内にPHが改善したのは,9人のうち8人の患者でした.
- 2人の患者 (22%) がフォローアップ中に死亡し,ほとんどの患者で完全な回復は達成されなかった.
- ダサチニブにさらされた患者におけるPHの推定発生率は0.45%であった.
結論:
- ダサチニブは重度のプリキャピラーPHを誘発し,肺血管に直接作用することを示唆します.
- ダサチニブを中止すると,典型的にはPHの改善につながります.
- ダサチニブに関連したPHは重症であり,完全な回復をもたらさない場合があります.
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