首页> 外文期刊>Journal of the advanced practitioner in oncology >Management of Adverse Events Associated With Tyrosine Kinase Inhibitor Use in Adult Patients With Chronic Myeloid Leukemia in Chronic Phase: An Advanced Practice Perspective
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Management of Adverse Events Associated With Tyrosine Kinase Inhibitor Use in Adult Patients With Chronic Myeloid Leukemia in Chronic Phase: An Advanced Practice Perspective

机译:慢性期慢性骨髓白血病成年患者使用酪氨酸激酶抑制剂的不良事件管理:高级实践视角

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摘要

The tyrosine kinase inhibitors (TKIs) imatinib, dasatinib, nilotinib, bo-sutinib, and ponatinib have drastically improved the life expectancies of patients with chronic myeloid leukemia in chronic phase (CML-CP). While survival outcomes are comparable across first-line TKIs, each TKI has a unique toxicity profile that should be considered before starting or managing any treatment. Furthermore, the safety and tolerability of TKIs are particularly important in CML-CP, as the majority of patients remain on treatment for several years or for life. Management of adverse events (AEs) is critical to ensure adherence to treatment and to maintain efficacy and quality of life; management should also be considered in the context of the patient’s molecular response to therapy to avoid switching TKIs unnecessarily. We present case studies examining pleural effusion occurring with bosutinib and dasatinib, cardiovascular events associated with nilotinib and ponatinib, and myelosuppression, which is common across all TKIs. We discuss the management of these AEs based on international guidelines and present our collective experience for advanced practitioners to consider.
机译:酪氨酸激酶抑制剂(TKIs)伊马替尼、达沙替尼、尼罗替尼、博苏替尼和波纳替尼显著提高了慢性粒细胞白血病慢性期(CML-CP)患者的预期寿命。虽然一线TKI的生存结果具有可比性,但每种TKI都有独特的毒性特征,在开始或管理任何治疗之前都应予以考虑。此外,TKIs的安全性和耐受性在CML-CP中尤为重要,因为大多数患者仍在接受数年或终身治疗。不良事件(AE)的管理对于确保坚持治疗、维持疗效和生活质量至关重要;管理也应结合患者对治疗的分子反应来考虑,以避免不必要地转换TKI。我们提出的病例研究检查了博斯汀替尼和达沙替尼引起的胸腔积液、尼罗替尼和波纳替尼引起的心血管事件,以及所有TKI中常见的骨髓抑制。我们讨论的管理这些AES的国际准则,并提出我们的集体经验,先进的从业者考虑。

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