阿帕替尼致咯血并心律失常1例分析

doi:10.19803/j.1672-8629.2021.09.21

摘要/Abstract

摘要： 目的分析阿帕替尼治疗晚期肉瘤过程中出现的不良反应特点。方法总结1例晚期黏液纤维肉瘤患者服用阿帕替尼后出现不良反应的病例,并复习相关文献。结果阿帕替尼已被证明在标准多模式治疗失败后能延长晚期肉瘤的无进展生存期。本例晚期黏液纤维肉瘤经多线治疗后予阿帕替尼单药靶向治疗,无进展生存期达到5个月。患者在治疗过程中,合并咯血、心律失常,考虑药品不良反应所致,心律失常在停药2周后得到纠正,后期患者出现不完全性肠梗阻,将阿帕替尼减量治疗,后肠梗阻逐渐减轻。随后患者出现III°血小板减少,考虑阿帕替尼所致重度骨髓抑制,患者在用药过程中出现一系列不良反应,给予动态评估及动态调整阿帕替尼用法用量,取得了良好的疾病客观缓解,其中重度骨髓抑制是一种新的、严重的药品不良反应。结论应加强阿帕替尼在晚期肉瘤中的用药监测,本案例中,医师及时、准确地获取和确诊相关症状并施以针对性的治疗方案,为阿帕替尼个体化合理使用与及时发现和诊断提供了宝贵的临床经验和指导。

关键词: 阿帕替尼, 黏液纤维肉瘤, 不良反应, 骨髓抑制

Abstract: Objective To analyze the characteristics of adverse reactions in the treatment of advanced sarcomas with apatinib. Methods One case of ADRs in a patient with advanced myxofibrosarcoma was summarized and the relevant literature was reviewed. Results Apatinib has been shown to prolong the progression-free survival of patients with advanced sarcomas after failure of standard multimodality therapies. In this case, advanced myxofibrosarcoma was treated with multiple lines and then with apatinib, with a progression-free survival of 5 months. In the course of treatment, the patient suffered from hemoptysis and arrhythmia that were considered to have been caused by adverse drug reactions. Arrhythmia was corrected two weeks after drug withdrawal, and incomplete intestinal obstruction occurred in this patient at the later stage. The dosage of apatinib was reduced, and postoperative intestinal obstruction was gradually ameliorated. Then, the patient suffered from III thrombocytopenia, so severe bone marrow suppression was considered. A series of other adverse reactions also occurred so that the usage and dosage of apatinib were adjusted dynamically, and to good effect. Conclusion The clinical use of apatinib against advanced sarcomas should be monitored more vigorously. Quick and accurate diagnosis of the related symptoms and targeted treatment plans are critical to the safety of patients.

Key words: apatinib, myxofibrosarcoma, adverse reactions, myelosuppression

中图分类号:

R969.3

青晓艳, 曾晓梅. 阿帕替尼致咯血并心律失常1例分析[J]. 中国药物警戒, 2021, 18(9): 890-893.

QING Xiaoyan, ZENG Xiaomei. Hemoptysis and Arrhythmia Induced by Apatinib: A Case Report[J]. Chinese Journal of Pharmacovigilance, 2021, 18(9): 890-893.

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