氨酸激酶抑制剂在慢性髓性白血病中对甲状腺功能的影响:系统性审查
Nana Sardarova1, Tirath Patel2, Tahani M Abugoukh1,3
1Internal Medicine, Henry Ford Health System, Warren, USA.
Cureus
|July 2, 2025
概括
用于慢性骨髓性白血病 (CML) 的氨酸激酶抑制剂 (TKIs) 可以导致甲状腺功能障碍,最常见的是亚临床甲状腺功能低下症. 自身免疫性甲状腺炎可能表明对TKI治疗的反应更好.
科学领域:
- 内分泌学 在内分泌学.
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 氨酸激酶抑制剂 (TKIs) 已经改变了慢性髓性白血病 (CML) 的治疗方法.
- 泰基药物越来越多地与内分泌系统的不良影响有关,特别是甲状腺功能障碍.
研究的目的:
- 系统地审查CML患者TKI诱导的甲状腺异常的患病率,临床特征,机制和预后影响.
主要方法:
- 在PubMed,Embase,ClinicalKey和谷歌学者中进行了系统的文献搜索,遵守PRISMA 2020指南.
- 在使用NOS和AMSTAR 2进行质量评估后,包括了8项研究 (六项观察性,两项系统性审查).
主要成果:
- 亚临床甲状腺功能障碍是最常见的TKI诱导的甲状腺功能障碍,特别是在伊马替尼和第二代TKI.
- 机制包括甲状腺炎,降低的吸收,VEGF抑制,MCT8运输抑制和改变的二氧化酶活性.
- 自身免疫性甲状腺炎与对TKI的改善分子反应有关,这表明生物标志物的潜力.
结论:
- 在TKI治疗CML期间,定期监测甲状腺功能至关重要.
- 甲状腺自身免疫可能对TKI疗效有预后影响.
- 需要进一步的研究来标准化监测和了解甲状腺变化在CML管理中的临床意义.
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