TOXICITY AND EFFICACY OF TYROSINE KINASE INHIBITORS IN COMBINATION WITH CHEMOTHERAPY IN PATIENT WITH RESISTANT Ph-POSITIVE ACUTE LYMPHOBLASTIC LEUKEMIA (CASE REPORT AND LITERATURE REVIEW)

Abstract

A wide range of toxic complications of BCR-ABL tyrosine kinase inhibitors therapy due to non-targeted inhibition of other protein kinases. This is of particular importance in the treatment of patients with Ph-positive lymphoblastic leukemia, who receive, in addition to tyrosine kinase inhibitors, cytotoxic drugs, enhancing myelotoxicity and, as a consequence, infections and thrombo-hemorrhagic complications. In addition, complex inter-drug interactions lead to the manifestations of combined toxicity. This article presents a case report of patient with relapsed acute Ph-positive lymphoblastic leukemia, treatment of which was accompanied by numerous complications, especially during treatment of II and III generation tyrosine kinases inhibitors.

Keywords

• ph-positive acute lymphoblastic leukemia
• tyrosine kinase inhibitors
• selectivity
• combined toxicity
• t315i mutation
• imatinib
• nilotinib
• dasatinib
• axitinib
• ponatinib
• blinatumomab