在慢性阶段慢性髓性白血病的管理中剂量修改:谁,什么,什么时候
Vivian G Oehler1,2, Ivan J Huang3,4, Chloe Siu3,4
11Division of Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle WA.
Journal of the National Comprehensive Cancer Network : JNCCN
|November 13, 2024
概括
减少氨酸激酶抑制剂 (TKI) 剂量可以通过管理不良事件来改善慢性髓性白血病 (CML) 患者的生活质量. 慢性阶段CML (CP-CML) 的小心减少剂量旨在保持优良的治疗结果.
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:
- 氨酸激酶抑制剂 (TKIs) 显著改善了慢性阶段慢性髓性白血病 (CP-CML) 的治疗结果.
- 来自TKIs的治疗出现的不良事件 (TEAE) 对患者的生活质量产生负面影响,影响日常功能和福祉.
- 剂量减少越来越被认为是管理与TKI治疗相关的慢性不良事件的策略.
研究的目的:
- 审查关于接受TKI剂量减少的CP-CML患者结局的数据.
- 评估低剂量预防性TKI剂量策略的有效性和安全性.
- 讨论剂量降低作为提高耐受性和生活质量的经济有效方法的作用.
主要方法:
- 综述了关于TKI降低CP-CML剂量的回顾性和前性研究.
- 分析支持各种治疗线的预防性低剂量TKI策略的数据.
- 讨论新兴的治疗方法,包括全抑制剂.
主要成果:
- 降低剂量可以改善TEAE和CP-CML患者的生活质量.
- 数据表明,降低剂量可以保持优秀的治疗结果.
- 切换TKI可能会减轻一些TEAE,但可能引入新的毒性.
结论:
- 降低剂量是一种可行的策略,可以将TEAE降至最低,并提高CP-CML患者的生活质量.
- 通过仔细的剂量管理,可以保持最佳结果并提高耐受性.
- 随着TKIs变得通用,降低剂量为长期CP-CML管理提供了具有成本效益的方法.
相关概念视频
01:11Renal Failure: Dose Adjustments
67
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
67
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
3.9K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
3.9K
01:01Dosage Regimen: Fixed Dose
1.9K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.9K
01:15Drug Dosage Regimen: Overview
3.5K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.5K
02:50Combination Therapies and Personalized Medicine
4.9K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.9K
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
142
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
142