伊马替尼治疗慢性粒细胞白血病引起严重骨髓抑制及个体化用药的体会与思考

Imatinib induced severe bone marrow suppression in the treatment of chronic myelognous leukemia and individualized administration

目的通过对1例伊马替尼不良反应的评价,探讨该不良反应处理对策和药物的合理使用。方法临床药师对1例伊马替尼治疗慢性粒细胞白血的患者追踪随访,及时对其用药疗效及安全性进行分析,通过查阅及总结相关文献,协助医师制定个体化用药方案。结果伊马替尼引起的严重骨髓抑制是一个可逆的过程,通常在停药或减量、对症支持治疗后好转,临床可以根据实验室检查及患者个体情况调整用药,以保证用药的有效性和安全性。结论药物不良反应是影响患者依从性及药物疗效的重要因素,因此,药师协助医师进行个体化给药,有利于保证患者疗效和安全性。

Objective To discuss the adverse reactions of imatinib, its treatment and rational administration. Methods Clinical pharmacists followed a case of imatinib in the treatment of chronic myelognous leukemia, and analyzed the efficacy and safety of imatinib, by pooling relevant literatures, and developing individualized administration plan. Results Imatinib induced severe bone marrow suppression, but it was reversed by dose interruption, dose reduction, and some symptomatic treatment. Individualized administration is a necessary move to ensure its effectiveness and safety. Conclusion Adverse drug reactions are important factors to influence patient compliance and drug effect. Pharmacists may help physicians in individualized administration to improve drug efficacy and safety in patients.