用达沙提尼布治疗的患者的肺动脉高血压
David Montani1, Emmanuel Bergot, Sven Günther
1Univ. Paris-Sud, Faculté de Médecine, Le Kremlin-Bicêtre, France.
Circulation
|March 28, 2012
概括
在慢性骨髓性白血病患者中,达沙替尼可能会导致严重的毛囊前肺高血压 (PH). 停止使用达沙替尼布通常会改善PH,但不能保证完全恢复.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 肺高血压 (PH) 是慢性骨髓性白血病 (CML) 治疗的已知并发症.
- 铁氨酸激酶抑制剂 (TKIs),如达沙替尼,用于治疗CML.
- 在接受达沙替尼治疗的患者中报告了单独的毛囊前PH病例.
研究的目的:
- 为了描述与达沙替尼布相关的PH的偶发病例.
- 分析这些患者的临床表现,治疗和结果.
- 为了估计暴露在达沙替尼布的患者中PH的发生率.
主要方法:
- 对9例PH病例的回顾性分析,这些病例在用达沙替尼治疗的患者中被诊断为PH.
- 从2006年11月至2010年9月期间从法国PH登记处收集的数据.
- 在停用达沙替尼之前和之后评估临床,功能和血液动力学参数.
主要成果:
- 所有9名患者都呈现出中度至重度的毛囊前PH.
- 在9名患者中,8名患者的PH在停用达沙替尼布后4个月内改善.
- 两名患者 (22%) 在随访期间死亡;大多数患者没有完全康复.
- 达沙替尼布暴露患者中PH的估计发病率为0.45%.
结论:
- 达沙替尼可能会诱导严重的毛囊前PH,这表明它对肺血管有直接影响.
- 停用达沙替尼布通常会导致PH的改善.
- 与达沙提尼布相关的PH可能是严重的,可能不会导致完全康复.
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