A Pragmatic Approach to Managing Long-Term Adverse Effects in Chronic Myeloid Leukemia Treatment.

IF 2.7 3区 医学 Q2 HEMATOLOGY Current Hematologic Malignancy Reports Pub Date : 2023-08-01 DOI:10.1007/s11899-023-00698-4
Josephine Anne Lucero, Jeffrey H Lipton
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Abstract

Purpose of review: Long-term outcomes have significantly improved with treatment of chronic myeloid leukemia. With proper treatment, most patients will achieve similar survival rates compared to an age-matched population. Treatment-free remission is not attainable for over half of patients and chronic treatment carries with it unique challenges. We provide a pragmatic approach to the monitoring and management of chronic adverse effects (AEs).

Recent findings: In the presence of severe or intolerable AEs, switching tyrosine kinase inhibitors (TKIs) is reasonable but is not without risk. Dose reductions can be attempted when response is stable to reduce AE intensity. More frequent molecular monitoring with any change is essential. Treatment strategies must adapt to the personalized treatment goal of each patient. Long-term survival remains good even when response is less than a complete molecular response. Consider risks of new AEs when changing therapy and evaluate for dose reductions when appropriate.

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治疗慢性髓性白血病长期不良反应的实用方法。
综述的目的:慢性髓性白血病治疗后的长期预后显著改善。通过适当的治疗,大多数患者的生存率与年龄匹配的人群相似。超过一半的患者无法实现无治疗缓解,慢性治疗带来了独特的挑战。我们提供一种实用的方法来监测和管理慢性不良反应(ae)。最近的研究发现:在出现严重或无法忍受的不良事件时,改用酪氨酸激酶抑制剂(TKIs)是合理的,但并非没有风险。当反应稳定时,可以尝试减少剂量以降低声发射强度。更频繁地监测任何变化都是必要的。治疗策略必须适应每位患者的个性化治疗目标。即使反应不是完全的分子反应,长期生存率仍然很好。在改变治疗时考虑新的不良反应的风险,并在适当的时候评估减少剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.00
自引率
0.00%
发文量
28
审稿时长
>12 weeks
期刊介绍: his journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hematologic malignancy. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as leukemia, lymphoma, myeloma, and T-cell and other lymphoproliferative malignancies. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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