青少年服用格列卫、尼罗替尼、达沙替尼的结果2012-02-06 19:29:39 文字大小：【大】【中】【小】
This is a study from MD Anderson Cancer Center of 61 adolescents and young adults (61 patients in all) and their outcome on Gleevec, Sprycel and Tasigna compared to adult patients (adolescents and young adult age being 15-29 years). The follow-up time on the TKIs were about 5 years and the outcome was not as good as adult patients. While the overall survival and transformation-free survival of the young adults were similar to adults on TKIs, the event-free survival was lower at 71% versus 82% with more young adults having to change their first TKI due to lower response rate. Tasigna and Sprycel gave better CCR rates at 1 year for the young adults compared to Gleevec but the MMR rates were slow for all TKIs compared to the adult population. This is the first study giving the side-effects profile of young adults on all three drugs, Gleevec gave more variety of side-effects at low percentages but Tasigna and Sprycel had a higher incidence of a specific side-effect like 38% of young adults had liver problems on Tasigna and 31% had bone pain on Sprycel. Those whose children have reached CCR and MMR on any TKI, no worries and for those who are caregiving for a young adult taking time to reach remission, you are not alone. Find below the link to the entire article and the abstract is also given. The doctors deem the results surprising and are looking into why the young adult population respond less favorably to TKIs compared to adults.
Analysis of outcomes in adolescents and young adults with chronic myelogenous
leukemia treated with upfront tyrosine kinase inhibitor therapy
1.. Naveen Pemmaraju,
2.. Hagop Kantarjian,
3.. Jianqin Shan,
4.. Elias Jabbour,
5.. Alfonso Quintas-Cardama,
6.. Srdan Verstovsek,
7.. Farhad Ravandi,
8.. William Wierda,
9.. Susan O' Brien and
10.. Jorge Cortes*
+ Author Affiliations
1.. University of Texas MD Anderson Cancer Center, USA
1.. ?* Corresponding author; email: jcortes#（发送邮件时请替换为@）...
Background:Outcomes in chronic myeloid leukemia have improved with tyrosine kinase inhibitor treatment.Little is known about outcomes of chronic myeloid leukemia dolescent and young adult patients.Design and Methods: We reviewed all 468 chronic myeloid leukemia patients treated at our institution with tyrosine kinase inhibitors as initial therapy: imatinib (n=281), nilotinib (n=98), or dasatinib (n=89). Results:For the entire population median age was 47 years, median follow up 71 months, and median treatment time with initial tyrosine kinase inhibitors, 48 months.Adolescent and young adult was defined as age 15-29 years. Sixty-one adolescent and young adult patients were identified. Only significant difference between adolescent and young adult and older patients was splenomegaly. Only 3 adolescent and young adult patients have died.Rates of complete cytogenetic, major molecular and complete molecular response were significantly higher in older patients compared to adolescent and young adult, with a favorable trend in event-free survival for older patients. Transformation-free and overall survival were similar for the two groups. Conclusions: The unfavorable trend in outcome for adolescent and young adult with chronic myeloid leukemia is unexpected. Additional research in this population is required to better define outcomes, understand the cause of this difference, and to help make better treatment recommendations.