2022, Number 1
Etiopathogenesis, therapeutic management and geriatric considerations in chronic myeloid leukemia: a comprehensive review
Language: Spanish
References: 20
Page:
PDF size: 224.93 Kb.
ABSTRACT
Introduction: Chronic myeloid leukemia (LMC) is a chronic myeloproliferative neoplasm characterized by the clonal expansion of mature myeloid cells. Its global incidence peaks in adults over 65 years of age, a group in which 40% of cases are diagnosed. Although tyrosine kinase inhibitors (TKIs) have revolutionized their prognosis, challenges persist in older patients with comorbidities, polypharmacy, and frailty that increase the risk of toxicity and can hinder therapeutic adherence.Objective: To systematize knowledge on advances in pathogenesis, treatment and geriatric management of Chronic Myeloid Leukemia.
Method: Review in PubMed, Scopus and Cochrane Library (2010-2022) with the terms “BCRABL1”, “tyrosine kinase inhibitors” and “geriatric assessment”.
Results: Third-generation TKIs (e.g., asciminib) improve responses in T315I mutations. In the context of LMC, VGI is particularly useful for assessing the tolerability of tyrosine kinase inhibitors (TKIs) in older patients. VGI can help identify patients who require dose adjustments or closer monitoring to detect and manage side effects.
Conclusions: Therapeutic personalization based on molecular profile and frailty optimizes outcomes in Chronic Myeloid Leukemia in older patients.
REFERENCES
Cañizalez JZ, Rojas de Atencio A, Urdaneta K, Atencio Rojas R, González R, Soto Met al. Transcritos del gen BCR-ABL, en pacientes con leucemia Mieloide crónica enVenezuela. Saber [Internet]. 2015 Sep [citado 2022 Mar 12]; 27(3): 422-429. Disponibleen: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S1315-01622015000300008&lng=es.
Rodríguez M, Cardona AF, Grajales MA, Enciso L, Ruiz G, Yepes A et al. Leucemiamieloide crónica en crisis blástica bases moleculares y diagnóstico. Rev. venez. oncol.[Internet]. 2007 Dic [citado 2022 Mar 12];19(4):287-296. Disponible en:http://ve.scielo.org/scielo.php?script=sci_arttext& pid=S0798-05822007000400003&lng=es.
Döhner H, Wei AH, Appelbaum FR, Craddock C, DiNardo CD, Dombret H, et al. Diagnosisand management of AML in adults: 2022 recommendations from an internationalexpert panel on behalf of the ELN. Blood. 2022;140(12):1345–1377. https://doi.org/10.1182/blood.2022016867. Disponible en: https://ashpublications.org/blood/article/140/12/1345/485817/Diagnosis-and-management-of-AML-in-adults-2022
Rodríguez Couso Myriam. Intervenciones geriátricas en el mayor con cáncer basadasen la valoración geriátrica integral. Áreas de optimización: lo que el geriatra puedeaportar al equipo multidisciplinar. Nutr. Hosp. [Internet]. 2020 [citado 2022 Mar 12];37(spe1): 38-47. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112020000200004 &lng=es. https://dx.doi.org/10.20960/nh.02988.
15.Richter Lucia, Revollo Ariana, Silveyra Noelia, Lladó Natalia, Kmaid Ana, Ubillos Luis.Evaluación geriátrica guiada por G8 en la decisión del tratamiento de adultos mayorescon cáncer. Un estudio piloto. Anfamed [Internet]. 2020 [citado 2022 Mar 12]; 7 (2):e201. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S2301-12542020000201201&lng=es. https://doi.org/10.25184/ anfamed 2020v7n2a1.
16.Bonanad S, De la Rubia J, Gironella M, Pérez Persona E, González B, Fernández LagoC; GAH Group. Development and psychometric validation of a brief comprehensivehealth status assessment scale in older patients with hematological malignancies: TheGAH Scale. J Geriatr Oncol. 2015 Sep;6(5):353-61. doi: 10.1016/j.jgo.2015.03.003.Epub 2015 Jun 29. PMID: 26139300.
18.Khoury JD, Solary E, Abla O, Akkari Y, Alaggio R, Apperley JF, et al. The 5th edition ofthe World Health Organization Classification of Haematolymphoid Tumours: Myeloidand Histiocytic/Dendritic Neoplasms. Leukemia. 2022 Jul;36(7):1703-1719. doi:10.1038/s41375-022-01613-1. Epub 2022 Jun 22. PMID: 35732831; PMCID:PMC9252913.
19.Hoch M, Huth F, Sato M, Sengupta T, Quinlan M, Dodd S, Kapoor S, Hourcade-Potelleret F. Pharmacokinetics of asciminib in the presence of CYP3A or P-gp inhibitors,CYP3A inducers, and acid-reducing agents. Clin Transl Sci. 2022 Jul;15(7):1698-1712. doi: 10.1111/cts.13285. Epub 2022 May 26. PMID: 35616006; PMCID:PMC9283742