METHOD FOR MANAGING PATIENTS WITH CHRONIC MYELOID LEUKEMIA IN PRESCRIBING TYROSINE KINASE INHIBITORS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to oncology, haematology and cardiology, and can be used for managing patients with chronic myeloid leukaemia in prescribing tyrosine kinase inhibitors (TKI). Cardiovascular system is examined, and a ten-year risk of cardiovascular mortality is assessed by the SCORE scale. Prior to prescribing the treatment, it is necessary to determine presence or absence of ischemic heart disease (IHD) in the patient. If there is no ischemic heart disease with low and medium SCORE risk, the patient is prescribed one of the following preparations: imatinib, dasatinib, nilotinib, bosutinib, ponotinib, after which once in 3 months: the patient is examined by a hematologist, the patient is biochemically analyzed for total cholesterol, a lipid spectrum, glucose, B-type natriuretic peptide, NT-proBNP, troponins, electrocardiography, echocardiography, bicycle ergometry, control of arterial pressure. Dascplerography of the brachiocephalic trunk is performed once in 6 months. If nilotinib is prescribed, the patient is examined by a haematologist and all the above-mentioned studies, except for ultrasonic Doppler sonography of the brachiocephalic trunk, should be performed once a month, and ultrasonic Doppler sonography of the brachiocephalic trunk once in 3 months. If observing no adverse events, the patient is required to be examined by a therapist and cardiologist once every 6 months. If observing the adverse events, the therapist and the cardiologist are examined once a month, reducing frequency to 1 every 6 months with the elimination of the adverse events. If the patient has a high and very high SCORE risk in the absence or presence of IHD, he is prescribed one of the following preparations: imanitib, dasatinib, bozutinib. Thereafter, once a month: a patient is examined by a hematologist, the patient is examined biochemically for total cholesterol, a lipid spectrum, glucose, B-type natriuretic peptide, NT-proBNP, troponins, electrocardiography, echocardiography, bicycle ergometry, control of arterial pressure. Doppler sonography of the brachiocephalic trunk is performed once in 3 months. If observing no adverse events, the patient is examined by a therapist and cardiologist once every 3 months. If observing the undesirable events, the patient is examined by the therapist and cardiologist once a month, reducing the frequency of adverse events by 1 time in 6 months.;EFFECT: method provides preventing the development of IHD in the patients with chronic myeloid leukaemia when prescribing TKI, as a result of the use of a clear scheme of prescribing any TKI, monitoring the occurrence of adverse events, determining the order of examination of the patient in case of adverse events.;1 cl, 4 ex