关键词: Hematologic toxicity neutropenia omacetaxine mepesuccinate supportive care thrombocytopenia

Mesh : Adult Aged Aged, 80 and over Antineoplastic Agents, Phytogenic / adverse effects therapeutic use Antineoplastic Combined Chemotherapy Protocols / adverse effects therapeutic use Blood Transfusion Disease Management Female Harringtonines / adverse effects therapeutic use Homoharringtonine Humans Incidence Leukemia, Myeloid, Accelerated Phase / complications drug therapy Leukemia, Myeloid, Chronic-Phase / complications drug therapy Leukocyte Count Male Middle Aged Pancytopenia / diagnosis epidemiology etiology therapy Treatment Outcome Young Adult

来  源:   DOI:10.3109/10428194.2015.1071486   PDF(Sci-hub)

Abstract:
Omacetaxine mepesuccinate (Synribo) is an inhibitor of protein synthesis indicated for the treatment of patients with chronic- or accelerated-phase chronic myeloid leukemia (CML) with resistance and/or intolerance to two or more tyrosine kinase inhibitors. Myelosuppression is the most common and clinically significant toxicity experienced by patients treated with omacetaxine. Here, we further examine the patterns of hematologic toxicity observed in clinical trials and describe the approach to management as well as resolution of events. Omacetaxine-related myelosuppression typically occurs more frequently during induction cycles. In general, the myelosuppression observed with omacetaxine treatment is manageable and reversible, and long-term administration is feasible. Careful monitoring, dose delays and reduction in administration days, and appropriate supportive care are critical for successful management of hematologic toxicity. Concerns regarding myelosuppression, observed with many cancer treatments, should not prevent eligible patients from receiving omacetaxine, particularly CML patients with unsatisfactory responses to multiple lines of prior treatment.
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