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European LeukemiaNet recommendations for the management and avoidance of adverse events of treatment in chronic myeloid leukaemia
- Source :
- LEUKEMIA, Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, Leukemia
- Publication Year :
- 2016
-
Abstract
- Most reports on chronic myeloid leukaemia (CML) treatment with tyrosine kinase inhibitors (TKIs) focus on efficacy, particularly on molecular response and outcome. In contrast, adverse events (AEs) are often reported as infrequent, minor, tolerable and manageable, but they are increasingly important as therapy is potentially lifelong and multiple TKIs are available. For this reason, the European LeukemiaNet panel for CML management recommendations presents an exhaustive and critical summary of AEs emerging during CML treatment, to assist their understanding, management and prevention. There are five major conclusions. First, the main purpose of CML treatment is the antileukemic effect. Suboptimal management of AEs must not compromise this first objective. Second, most patients will have AEs, usually early, mostly mild to moderate, and which will resolve spontaneously or are easily controlled by simple means. Third, reduction or interruption of treatment must only be done if optimal management of the AE cannot be accomplished in other ways, and frequent monitoring is needed to detect resolution of the AE as early as possible. Fourth, attention must be given to comorbidities and drug interactions, and to new events unrelated to TKIs that are inevitable during such a prolonged treatment. Fifth, some TKI-related AEs have emerged which were not predicted or detected in earlier studies, maybe because of suboptimal attention to or absence from the preclinical data. Overall, imatinib has demonstrated a good long-term safety profile, though recent findings suggest underestimation of symptom severity by physicians. Second and third generation TKIs have shown higher response rates, but have been associated with unexpected problems, some of which could be irreversible. We hope these recommendations will help to minimise adverse events, and we believe that an optimal management of them will be rewarded by better TKI compliance and thus better CML outcomes, together with better quality of life.
- Subjects :
- Cancer Research
medicine.medical_specialty
Drug-Related Side Effects and Adverse Reactions
medicine.drug_class
Review
Tyrosine-kinase inhibitor
03 medical and health sciences
European LeukemiaNet
0302 clinical medicine
Quality of life
Internal medicine
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
medicine
Humans
Adverse effect
Intensive care medicine
Protein Kinase Inhibitors
Hematology
business.industry
Imatinib
Protein-Tyrosine Kinases
medicine.disease
3. Good health
Review article
Surgery
Oncology
030220 oncology & carcinogenesis
business
030215 immunology
medicine.drug
Chronic myelogenous leukemia
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- LEUKEMIA, Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, Leukemia
- Accession number :
- edsair.doi.dedup.....c9d5248c9dd270e0c0dcc8b099cb874b