[慢性髓性白血病的当前管理和新治疗策略]
Martina Crysandt1,2, Tim H Brümmendorf1,2
1Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Uniklinik RWTH Aachen, Aachen, Deutschland.
Deutsche medizinische Wochenschrift (1946)
|May 31, 2023
概括
氨酸激酶抑制剂 (TKIs) 已经改变了慢性髓性白血病 (CML) 治疗,改善了生存率. 了解和管理TKI的副作用,特别是长期的副作用,对于患者的生活质量和个性化治疗选择至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 口服的氨酸激酶抑制剂 (TKIs) 显著改善了慢性髓性白血病 (CML) 患者的治疗结果,使慢性阶段 (CP) 的预期寿命接近正常.
- 尽管有进展,但大多数CP患者需要终身TKI治疗,这突显了了解和管理与治疗相关的副作用的重要性.
- 预先存在的并发症越来越被认为是长期存活的重要预测因素,影响TKI治疗选择和患者管理.
研究的目的:
- 强调对TKI副作用的全面知识的关键需求,包括它们的分级,动力学,持续时间,可逆性和对生活质量的影响.
- 倡导基于个体患者的并发病和并发药物的个性化TKI选择.
- 促进以患者为中心的方法来长期管理和预防TKI诱导的毒性.
主要方法:
- 对CML中TKI治疗现有知识的审查和综合.
- 分析TKI副作用对患者生活质量的影响.
- 在TKI治疗策略中考虑患者的并发症和并发药物.
主要成果:
- 很大一部分CML患者实现了无治疗缓解,但大多数仍在长期接受TKI治疗.
- 慢性,低度的TKI毒性可以大大降低患者自我评估的生活质量.
- 伴随性疾病可能比CML本身对长期生存更为关键,需要仔细的TKI选择.
结论:
- 对TKI副作用的彻底理解对于有效的患者医生关系和最佳治疗结果至关重要.
- 个性化TKI选择,考虑到并发症和联合治疗,对于最大限度地提高长期生存和生活质量至关重要.
- 长期管理应专注于预防和减轻TKI的副作用,其中一些可能是不可逆转的.
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