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首页> 外文期刊>European Journal of Haematology >Severe adverse events by tyrosine kinase inhibitors decrease survival rates in patients with newly diagnosed chronic‐phase chronic myeloid leukemia
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Severe adverse events by tyrosine kinase inhibitors decrease survival rates in patients with newly diagnosed chronic‐phase chronic myeloid leukemia

机译:酪氨酸激酶抑制剂的严重不良事件降低了新诊断的慢性阶段慢性骨髓白血病患者的存活率

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Abstract Objective This multicenter cooperative study aimed to analyze the adverse events ( AE s) associated with tyrosine kinase inhibitors ( TKI s) used as initial treatment for chronic‐phase chronic myeloid leukemia ( CML ‐ CP ) and their impact on outcome. Methods We retrospectively evaluated 450 patients with CML ‐ CP who received TKI s between 2004 and 2014. Results The 5‐year overall survival ( OS ) and event‐free survival ( EFS ) rates were 95.1% and 89.0%, respectively. Patients with comorbidities (46.4%) and aged ≥60?years (50.4%) at diagnosis had significantly inferior OS to those without comorbidities and aged 60. Patients achieved higher rates of major molecular response ( MMR ) at 6 and 12?months after initial treatment with dasatinib or nilotinib compared to imatinib, but final MMR rates were almost the same. Sixty‐six percent of patients required treatment modifications from first‐line TKI therapy; the main reasons were AE s (48.4%) and failure (18%). Grade III ‐ IV AE s in first‐line TKI therapy were significantly correlated to inferior OS / EFS compared to grade 0‐ II AE s. Conclusion Although long‐term outcomes were similar in CML ‐ CP patients treated with each TKI regardless of first‐line TKI selection, severe AE s in first‐line TKI therapy decreased their survival rates. Early change in TKI s is recommended, when faced with severe AE s of specific TKI s.
机译:摘要目的这项多中心合作研究旨在分析与酪氨酸激酶抑制剂(TKI S)相关的不良事件(AE S)用作慢性相慢性骨髓白血病(CML - CP)的初始治疗及其对结果的影响。方法采用2004年至2014年间接受TKI S的CML-CP患者的回顾性评估了450例CML - CP。结果分别为5年的整体生存(OS)和无需生存(EFS)率分别为95.1%和89.0%。患有合并症(46.4%)和≥60岁的患者(50.4%)对那些没有合并症的人具有显着劣质的操作系统,并且年龄60。患者在6和12的主要分子反应(MMR)率较高,与达斯替尼或尼洛替尼相比,与伊马替尼相比,但最终MMR速率几乎相同。六十六名患者从一线TKI治疗中需要治疗修饰;主要原因是AE S(48.4%)和失败(18%)。与0级AE S相比,第一线TKI治疗中的III级TKI治疗方法与较差的OS / EFS显着相关。结论虽然在每次TKI治疗的CML - CP患者中,无论第一线TKI选择如何,虽然长期成果类似,但一线TKI治疗中的严重AE S降低了它们的存活率。当面对特异性TKI S的严重AES时,建议使用TKI S的早期变化。

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