慢性阶段CML的后期管理:香港的共识建议
Carol Yuk Man Cheung1, Chung Yin Ha2, Bonnie Kho3
1Department of Medicine, Queen Mary Hospital, Hong Kong SAR, People's Republic of China. drcarolcheung@gmail.com.
Annals of hematology
|May 21, 2025
概括
新的指导方针为耐久性髓性白血病 (CML) 患者提供治疗策略,这些患者对多种氨酸激酶抑制剂 (TKI) 疗法有抗性. 这些建议涉及管理晚期CML病例,改善患者的治疗结果和生活质量.
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:
- 慢性髓性白血病 (CML) 的管理通常涉及长期的氨酸激酶抑制剂 (TKI) 治疗.
- 治疗耐药性或不耐受性需要连续使用TKI,高级病例的选择有限.
研究的目的:
- 制定基于证据的共识指导方针,用于管理慢性阶段的CML患者,这些患者之前至少两次TKI治疗失败了.
- 为了应对治疗顺序,耐药性,不耐受性和风险减轻在后期CML治疗中的挑战.
主要方法:
- 进行了文献审查,随后使用经过修改的Delphi流程与专家小组生成共识.
- 共识被定义为专家对治疗建议达成≥75%的共识.
- 通过面对面和在线代来完善建议,涵盖有效性,安全性和测序.
主要成果:
- 在五个关键话题中制定了17个共识声明.
- 主题包括定义治疗失败,可接受的反应,治疗顺序,控制耐药性和并发症,以及通过新型疗法和干细胞移植减轻风险.
- 这些指导方针涉及疗效,不耐受性,疾病进展,生活质量以及特定的患者亚组.
结论:
- 这些全面的指导方针为临床医生提供了关键的支持,以管理CML患者在第三线和后续线的治疗.
- 这些建议旨在优化治疗结果,预防疾病进展,提高耐火性CML患者的生活质量.
- 该共识为复杂的CML治疗方案的决策提供了一个框架,包括使用新型药物和全原干细胞移植.
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