PMID- 20345830
OWN - NLM
STAT- MEDLINE
DCOM- 20100824
LR  - 20201219
IS  - 1365-2702 (Electronic)
IS  - 0962-1067 (Linking)
VI  - 19
IP  - 9-10
DP  - 2010 May
TI  - Safety profiles of second-line tyrosine kinase inhibitors in patients with 
      chronic myeloid leukaemia.
PG  - 1207-18
LID - 10.1111/j.1365-2702.2009.03167.x [doi]
AB  - AIMS AND OBJECTIVES: To review the use of second-line tyrosine kinase inhibitors 
      in patients with chronic myeloid leukaemia (CML) and provide recommendations for 
      managing adverse events (AEs) to maximise patient benefit. BACKGROUND: Treatment 
      of CML has been revolutionised with the advent of tyrosine kinase inhibitors 
      (TKIs) that target the breakpoint cluster region-Abelson (BCR-ABL) kinase. 
      Imatinib is the only first-line TKI currently available for the treatment of CML; 
      however, intolerance and resistance remain significant clinical challenges. The 
      approved second-line treatment options for CML are dasatinib, nilotinib or 
      escalated-dose imatinib. DESIGN: Review article. METHODS: Searches of PubMed, 
      ASCO and ASH electronic databases for relevant search terms were performed 
      between July 2008-January 2009. FINDINGS: Dasatinib has no cross-intolerance with 
      imatinib, and the most frequent AEs (cytopenias and pleural and pericardial 
      effusions) can generally be managed by dose interruption and reduction. Nilotinib 
      has a high degree of haematologic cross-intolerance with first-line imatinib. As 
      might be expected, high-dose imatinib has the potential for more severe AEs than 
      standard-dose imatinib. CONCLUSIONS: There are known safety issues inherent to 
      each TKI and close monitoring by nursing staff is necessary to identify and 
      effectively manage AEs. RELEVANCE TO CLINICAL PRACTICE: All three TKIs have 
      demonstrated potential for fluid retention and cardiotoxicity. Nurses should be 
      aware of how these AEs manifest and intervene appropriately. The safety profiles 
      of these TKIs clearly differs and it is important to consider factors such as 
      comorbidities when making treatment decisions.
FAU - Tinsley, Sara M
AU  - Tinsley SM
AD  - Moffitt Cancer Center, Tampa, FL 33612, USA. sara.tinsley@moffitt.org
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20100316
PL  - England
TA  - J Clin Nurs
JT  - Journal of clinical nursing
JID - 9207302
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (Protein-Tyrosine Kinases)
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - Humans
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*drug therapy
MH  - Protein Kinase Inhibitors/adverse effects/*therapeutic use
MH  - Protein-Tyrosine Kinases/*antagonists & inhibitors
RF  - 39
EDAT- 2010/03/30 06:00
MHDA- 2010/08/25 06:00
CRDT- 2010/03/30 06:00
PHST- 2010/03/30 06:00 [entrez]
PHST- 2010/03/30 06:00 [pubmed]
PHST- 2010/08/25 06:00 [medline]
AID - JCN3167 [pii]
AID - 10.1111/j.1365-2702.2009.03167.x [doi]
PST - ppublish
SO  - J Clin Nurs. 2010 May;19(9-10):1207-18. doi: 10.1111/j.1365-2702.2009.03167.x. 
      Epub 2010 Mar 16.