酪氨酸激酶抑制剂治疗慢性粒细胞白血病的不良-中国现代应用药学.pdfVIP

酪氨酸激酶抑制剂治疗慢性粒细胞白血病的不良反应及临床对策  何思润 1 ，秦群 1 ，徐文泉 2*(1. 中南大学湘雅医院，长沙 410008 ；2.北京航空航天大学体育部，北京 100191) 摘要：酪氨酸激酶抑制剂(tyrosine kinase inhibitors ，TKIs)抑制 BCR-ABL 融合基因，使慢性粒细胞白血病(chronic myelocytic leukemia ，CML) 患者能够较长期生存。患者使用 TKIs 早期出现不良反应都较轻，可自行恢复或者给予对症处理和选择 其他 TKIs 。而 TKIs 长期的使用的安全性问题国内少有报道，本文通过查阅国内外文献，综述 TKIs 引起的骨髓、皮肤、 胃肠、肝和胰、骨骼肌、肺、液体潴留、心血管方面的不良反应以及其临床对策。 关键词：慢性粒细胞白血病；酪氨酸激酶抑制剂；不良反应 中图分类号：R979.1 文献标志码：A 文章编号：1007-7693(2016)07-0963-04 DOI: 10.13748/ki.issn1007-7693.2016.07.032 Adverse Events Associated with Tyrosine Kinase Inhibitors in Chronic Phase Chronic Myeloid Leukemia and Management 1 1 2* HE Sirun , QIN Qun , XU Wenquan (1.Xiangya Hospital of Central South University, Changsha 410013, China; 2.Beijing University of Aeronautics and Astronautics, Beijing 100191, China) ABSTRACT: Tyrosine kinase inhibitors(TKIs) targeting the BCR-ABL1 oncoprotein make patients who have diagnosed with chronic phase(CP) chronic myelocytic leukemia(CML) live long-term survival. Many patients may encounter adverse events usually occur early after treatment initiation which are mild to moderate in intensity and resolve spontaneously, or are easily controlled with adequate supportive care. However, long-term safety issues have not been fully elucidated at present, especially for new-generation TKIs. Recent evidence has emerged that these new agents may sometimes impinge on the heart and lung in an irreversible. review relevant TKIs adverse reactions as well as its management. KEY WORDS: chronic myeloid leukemia; tyrosine kinase inhibitors; adverse events 三磷酸腺苷(adenosine triphosphate，ATP)竞争 通过靶向或脱靶机制而引起一系列的不良反应。 性的酪氨酸激酶抑制剂(tyrosine kinase inhibitors， 此外，TKIs 是细胞色素 P450 酶系统中 CYP3A4