湖北省慢性髓系白血病患者口服TKI药物合并症调查结果和分析

吴要功; 王亚萍; 陈丽凤; 陈怡琳; 殷华; 熊颖媛; 黎纬明; 赵哲

doi:10.13201/j.issn.1004-2806.2018.11.011

湖北省慢性髓系白血病患者口服TKI药物合并症调查结果和分析

- 1. 华中科技大学同济医学院附属协和医院血液病研究所(武汉, 430022);
- 2. 武汉市第五医院;
- 3. 湖北民族学院附属民大医院△. 共同第一作者

详细信息

通讯作者: 赵哲,E-mail:445190618@qq.com

中图分类号: R733.72

收稿日期: 2018-08-14

Investigation and analysis of the complications of tyrosine kinase inhibitor in patients with chronic myeloid leukemia in Hubei Province

- 1. Institute of Hematology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, China;
- 2. Fifth Hospital in Wuhan;
- 3. Department of Hematology, Minda Hospital Affiliated to Hubei Institute for Nationalities

More Information

Corresponding author: ZHAO Zhe, E-mail: 445190618@qq.com

Received Date: 14 August 2018

摘要

摘要: 目的:评估湖北省慢性髓系白血病(CML)患者口服酪氨酸激酶抑制剂(TKI)后出现合并症的状况。方法:2015-11-2016-04在湖北省范围内,向正在接受TKI治疗的CML患者无记名发放调查问卷。结果:共发放问卷150份,收回123份,其中男性患者78例(63%),中位年龄45(11~72)岁,77例(63%)在诊断1年内开始TKI治疗,TKI中位治疗时间为42.5个月(<1年~12年);20%(25/123)患者口服TKI后出现合并症,92%(23/25)患者口服伊马替尼,口服TKI出现合并症的中位时间为36个月;1年内出现合并症患者10例,1~3年出现合并症者2例,3~5年出现合并症者5例,5年及以上出现合并症者8例。其中5例(4%)合并肿瘤,13例(11%)合并消化系统疾病,1例合并高血压,2例皮炎,1例腰椎间盘突出症,1例前列腺炎,1例咽喉肿块,1例痛性眼肌麻痹,相关科室就诊治疗后可坚持口服TKI药物。结论:部分CML患者口服TKI期间,可出现不同程度的合并症,在处理合并症的同时,为了不影响CML的治疗,需要多学科综合管理。
- 慢性髓系白血病 /
- 合并症 /
- 多学科综合管理
Abstract: Objective:To assess the complications status of tyrosine kinase inhibitor (TKI) in patients with chronic myeloid leukemia (CML) in Hubei Province.Method:From November 2015 to April 2016,anonymous questionnaires were distributed to CML patients who were receiving TKI treatment in Hubei Province.Result:A total of 150 questionnaires were put out and 123 were taken back.Seventy-eight (63%) cases out of 123 patients were male.The median age was 45 years (range,11 to 72 years).Seventy-seven (63%) of them started TKI treatment within one year after diagnosis.The median TKI treatment duration was 42.5 months (range,<1 to 12 years).Twenty-five patients (20%) had complications after TKI;92%(23/25) patients were treated with imatinib.The median time of complications occurring after TKI was 36 months.Ten patients developed complications within 1 year,2 patients within 1 to 3 years,5 patients within 3 to 5 years,and 8 patients developed complications 5 years later.Five of them (4%) had tumors,13 cases (11%) had digestive system diseases,1 case with hypertension,2 cases with rash,1 case with lumbar interwertebral discherniation,1 case with prostatitis,1 case with throat lumps and 1 case with painful ophthalmoplegia.The patients could continue TKI after treatment in relevant departments.Conclusion:Some patients with CML have different severity comorbidity after TKI.In order to not affect the treatment of CML,multidisciplinary comprehensive management is required when dealing with comorbidities.
- chronic myeloid leukemia /
- complication /
- multidisciplinary management

HTML全文

参考文献(14)

[1]	O'Brien S,Berman E,Borghaei H,et al.NCCN clinical practice guidelines in oncology:chronic myelogenous leukemia[J].J Natl Compr Canc Netw,2009,7:984-1023.
[2]	王杨,王京华.酪氨酸激酶抑制剂治疗慢性髓系白血病的现状及进展[J].临床血液学杂志,2013,26(3):214-216.
[3]	Jiang Q,Liu ZC,Zhang SX,et al.Young age and high cost are associated with future preference for stopping tyrosine kinase inhibitor therapy in Chinese with chronic myeloid leukemia[J].J Cancer Res Clin Oncol,2016,142:1539-1547.
[4]	Baccarani M,Deininger MW,Rosti G,et al.European LeukemiaNet recommendations for the management of chronic myeloid leukemia:2013[J].Blood,2013,122:872-884.
[5]	Hehlmann R,Lauseker M,Saussele S,et al.Assessment of imatinib as first-line treatment of chronic myeloid leukemia:10-year survival results of the randomized CML study IV and impact of non-CML determinants[J].Leukemia,2017,31:2398-2406.
[6]	任薇如,吕素娟,任娜娜.酪氨酸激酶抑制剂治疗慢性期老年人慢性粒细胞白血病的疗效及安全性分析[J].国际输血及血液学杂志,2016,39(6):471-475.
[7]	Gora-Tybor J,Medras E,Calbecka M,et al.Real-life comparison of severe vascular events and other non-hematological complications in patients with chronic myeloid leukemia undergoing second-line nilotinib or dasatinib treatment[J].Leuk Lymphoma,2015,56:2309-2314.
[8]	Saussele S,Krauss MP,Hehlmann R,et al.Impact of comorbidities on overall survival in patients with chronic myeloid leukemia:results of the randomized CML study IV[J].Blood,2015,126:42-49.
[9]	Miranda MB,Lauseker M,Kraus MP,et al.Secondary malignancies in chronic myeloid leukemia patients after imatinib-based treatment:long-term observation in CML Study IV[J].Leukemia,2016,30:1255-1262.
[10]	Verma D,Kantarjian H,Strom SS,et al.Malignancies occurring during therapy with tyrosine kinase inhibitors (TKIs) for chronic myeloid leukemia (CML) and other hematologic malignancies[J].Blood,2011,118:4353-4258.
[11]	Helbig G,Bober G,Seweryn M,et al.Occurrence of secondary malignancies in chronic myeloid leukemia during therapy with imatinib mesylate-single institution experience[J].Mediterr J Hematol Infect Dis,2015,7:e2015003.
[12]	Shah BK,Ghimire KB.Second primary malignancies in chronic myeloid leukemia[J].Indian J Hematol Blood Transfus,2014,30:236-240.
[13]	Gunnarsson N,Stenke L,Hoglund M,et al.Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era[J].Br J Haematol,2015,169:683-688.
[14]	吕敬龙,陈永平,肖青,等.格尼可一线治疗47例慢性髓系白血病患者的疗效与安全性观察[J].临床血液学杂志,2016,29(3):222-225.