Vascular adverse events in chronic myeloid leukaemia patients during tyrosine kinase inhibitor therapy in daily clinical practice – analysis from the INFINITY database
Authors:
P. Čičátková 1; D. Žáčková 1; T. Horňák 1; H. Klamová 2; P. Bělohlávková 3; L. Stejskal 4; Z. Křístková 5; J. Baranová 5; A. Kvetková 1; L. Semerád 1; J. Procházková 1; J. Mayer 1,6
Authors‘ workplace:
Interní hematologická a onkologická klinika LF MU a FN Brno
1; Ústav hematologie a krevní transfuze Praha
2; IV. interní hematologická klinika LF UK a FN Hradec Králové
3; Klinika hematoonkologie LF OU a FN Ostrava
4; Institut bio statistiky a analýz, s. r. o., Brno
5; Středoevropský technologický institut – MU, Brno
6
Published in:
Transfuze Hematol. dnes,29, 2023, No. 1, p. 29-37.
Category:
Original Papers
doi:
https://doi.org/10.48095/cctahd202329
Overview
The introduction of the first tyrosine kinase inhibitor imatinib into clinical practice has been associated with dramatical change in chronic myeloid leukaemia treatment over the past 20 years. It represents one of the biggest achievements in haematology and oncology per se. Imatinib was followed by second- and third generation tyrosine kinase inhibitors (nilotinib, dasatinib, bosutinib and ponatinib) resulting in newly diagnosed chronic myeloid leukaemia patients having almost the same life expectancy as the general population. Nevertheless, this often-lifelong treatment can be associated with side effects, which in extraordinary cases may be life threatening. Vascular adverse events are also included among such serious adverse events and their incidence varies over a wide range from 0.32–47.8%, most frequently in association with nilotinib or ponatinib treatment. Their incidence in daily clinical practice in the Czech Republic was evaluated in a retrospective analysis of the INFINITY database. From January 2005 to August 2020, chronic myeloid leukaemia was diagnosed in 1029 patients, with 1007 having valid records for analysis. Of these, 964 patients were in chronic phase. At least one vascular adverse event occurred in 82 patients (8.5%) in chronic phase during tyrosine kinase inhibitors therapy, most frequently in patients receiving nilotinib (10.8%) and ponatinib (8.3%). During first-line tyrosine kinase inhibitor treatment, 60 patients (6.3%) experienced at least one vascular adverse event. In direct comparison of first line imatinib and nilotinib therapy, we found a significantly higher incidence of cardiovascular (2.6 vs. 7.2%; P = 0.013), cerebrovascular (1.4 vs. 4.8%; P = 0.019), and peripheral vascular adverse events (0.2 vs. 4.0%; P = 0.001) in nilotinib treated patients, respectively. This paper offers a more detailed overview of vascular adverse event incidence in patients with chronic myeloid leukaemia treated with tyrosine kinase inhibitors in clinical practice in the Czech Republic and its comparison with available literature.
Keywords:
chronic myeloid leukaemia – Tyrosine kinase inhibitors – nilotinib – ponatinib – vascular adverse events – INFINITY
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Haematology Internal medicine Clinical oncologyArticle was published in
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