Кардиоваскулярная токсичность ингибиторов тирозинкиназы у пациентов с хроническим миелолейкозом

И.Л. Давыдкин1,2, К.В. Наумова1, А.М. Осадчук1, И.А. Золотовская1, О.Е. Данилова1, Т.Ю. Степанова1, О.В. Терешина1, Л.В. Лимарева3, А.С. Шпигель1, Т.П. Кузьмина1

1 ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России, ул. Чапаевская, д. 89, Самара, Российская Федерация, 443099

2 НИИ гематологии, трансфузиологии и интенсивной терапии СамГМУ, ул. Чапаевская, д. 89, Самара, Российская Федерация, 443099

3 Институт экспериментальной медицины и биотехнологий СамГМУ, ул. Чапаевская, д. 89, Самара, Российская Федерация, 443099

Для переписки: Ксения Викторовна Наумова, ул. Чапаевская, д. 89, Самара, Российская Федерация, 443099; тел.: +7(905)303-12-08; e-mail: senechka.naumova@rambler.ru

Для цитирования: Давыдкин И.Л., Наумова К.В., Осадчук А.М. и др. Кардиоваскулярная токсичность ингибиторов тирозинкиназы у пациентов с хроническим миелолейкозом. Клиническая онкогематология. 2018;11(4):378–87.

DOI: 10.21320/2500-2139-2018-11-4-378-387


РЕФЕРАТ

Настоящий обзор посвящен сердечно-сосудистым осложнениям у пациентов с хроническим миелолейкозом (ХМЛ) на фоне терапии ингибиторами тирозинкиназы (ИТК). Освещены современные представления о патогенезе кардиоваскулярной токсичности ИТК. Патофизиология сердечно-сосудистых заболеваний (ССЗ) рассматривается в свете современных представлений о так называемом патофизиологическом континууме — совокупности процессов, которые развиваются на молекулярном и клеточном уровнях еще до появления клинической симптоматики указанных заболеваний. Кардиоваскулярная токсичность отдельных ИТК у пациентов с ХМЛ может вносить свой вклад в прогрессирование патофизиологических процессов. Изучение механизмов, которые лежат в основе сердечно-сосудистых осложнений ИТК, важно для выявления рисков их развития у каждого конкретного больного. Определение предикторов развития ССЗ при терапии ИТК может помочь разработать схему мониторинга состояния сердечно-сосудистой системы и безопасного ведения пациентов с учетом индивидуальных рисков, а также избежать тяжелых угрожающих жизни осложнений.

Ключевые слова: хронический миелолейкоз, ингибиторы тирозинкиназы, нежелательные явления, кардиотоксичность, сердечно-сосудистые события.

Получено: 14 мая 2018 г.

Принято в печать: 29 августа 2018 г.

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Кожная токсичность гидроксикарбамида

И.Н. Суборцева, А.Л. Меликян, Е.А. Гилязитдинова, Т.И. Колошейнова, Е.И. Пустовая, Е.К. Егорова, А.М. Ковригина, А.Б. Судариков, А.О. Абдуллаев

ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4а, Москва, Российская Федерация, 125167

Для переписки: Ирина Николаевна Суборцева, канд. мед. наук, Новый Зыковский пр-д, д. 4а, Москва, Российская Федерация, 125167; e-mail: soubortseva@yandex.ru.

Для цитирования: Суборцева И.Н., Меликян А.Л., Гилязитдинова Е.А. и др. Кожная токсичность гидроксикарбамида. Клиническая онкогематология. 2018;11(3):252–58.

DOI: 10.21320/2500-2139-2018-11-3-252-258


РЕФЕРАТ

Гидроксикарбамид представляет собой противоопухолевое лекарственное средство, которое в основном используется при Ph-негативных миелопролиферативных заболеваниях и серповидноклеточной анемии. Язвы кожи — редкое, но серьезное нежелательное явление при длительной противоопухолевой терапии. Язвы, вызванные гидроксикарбамидом, часто множественные и двусторонние, обычно развиваются в области голеней, хотя могут наблюдаться практически в любой зоне. Язвы небольшого размера с четко определенными контурами, неглубокие, с желтым, покрытым фибрином основанием. Постоянным признаком является интенсивная боль, устойчивая к лечению и сопровождающая изъязвления. Элиминация препарата, как правило, приводит к спонтанному заживлению язвенных дефектов. Все пациенты, получающие гидроксикарбамид, должны проходить регулярный дерматологический скрининг. В настоящей статье представлены обзор литературы, посвященный кожной токсичности гидроксикарбамида, и описание клинического наблюдения.

Ключевые слова: гидроксикарбамид, нежелательные явления, дерматологический скрининг, Ph-негативные хронические миелопролиферативные заболевания.

Получено: 7 февраля 2018 г.

Принято в печать: 4 мая 2018 г.

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