芦可替尼治疗骨髓纤维化的不良反应及其应对研究进展

Research progress of adverse events and countermeasures of ruxolitinib in the treatment of myelofibrosis

骨髓纤维化(MF)是一种主要以全血细胞减少和(或)增多并伴有髓外造血、脾脏肿大、全身症状等为表现,最终进展为急性白血病的骨髓增殖性疾病。其发病机制尚未明确,目前认为Janus激酶-信号转导及转录活化因子(JAK-STAT)通路在其发病过程中起重要作用。芦可替尼(ruxolitinib)作为首个获得批准上市的JAK抑制剂,可有效缓解全身症状并减少脾肿大,延缓病情进展,降低等位基因负荷,并提高患者生活质量及生存率,但同时也会导致贫血、血小板减少、感染乃至继发恶性肿瘤等不良反应。本文主要介绍芦可替尼在骨髓纤维化治疗中导致的不良反应及其应对方法的研究进展。

Myelofibrosis(MF)is a myeloproliferative disease that mainly manifests as reduction and(or)increase of whole blood cells,accompanied by extramedullary hematopoiesis,splenomegaly,and systemic symptoms,and it eventually progresses to acute leukemia.Its pathogenesis is not yet clear.It is currently believed that the Janus kinase-signal transduc‐er and activator of transcription(JAK-STAT)pathway plays an important role in its pathogenesis.Ruxolitinib,as the first Janus kinase inhibitor approved for marketing,can effectively relieve systemic symptoms and reduce splenomegaly,delay disease progression,reduce allele load,and improve patients'quality of life and survival.But it can also lead to adverse events such as anemia,thrombocytopenia,infection and even secondary malignant tumors.This article mainly introduces the research progress of adverse reactions caused by ruxolitinib in the treatment of myelofibrosis and its countermeasures.