The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Cardiovascular events associated with use of tyrosine kinase inhibitors in chronic myeloid leukemia

På svenska

Author

  • Torsten Dahlén
  • Gustaf Edgren
  • Mats Lambe
  • Martin Höglund
  • Magnus Björkholm
  • Fredrik Sandin
  • Anders Själander
  • Johan Richter
  • Ulla Olsson-Strömberg
  • Lotta Ohm
  • Magnus Bäck
  • Leif Stenke
Show all

Summary, in English

Background: Tyrosine kinase inhibitors (TKIs) have increased survival dramatically for patients with chronic myeloid leukemia (CML), but continuous administration of these drugs may elicit long-term toxicity. Objective: To investigate the incidence of vascular events in patients with CML treated with first-and second-generation TKIs. Design: Retrospective cohort study using nationwide population-based registries. Setting: Sweden. Patients: All patients diagnosed with chronic-phase CML in Sweden from 2002 to 2012 and treated with a TKI, and 5 ageand sex-matched control individuals per patient. Measurements: Relative risks, expressed as incidence rate ratios comparing patients with control individuals, were calculated. Events per 1000 person-years were assessed in interdrug comparisons. Results: 896 patients, 94.4% with documented TKI treatment, were followed for a median of 4.2 years. There were 54 arterial and 20 venous events in the CML cohort, corresponding to relative risks of 1.5 (95% CI, 1.1 to 2.1) and 2.0 (CI, 1.2 to 3.3), respectively. The event rate for myocardial infarction was higher in patients treated with nilotinib or dasatinib (29 and 19 per 1000 person-years, respectively) than in those receiving imatinib (8 per 1000 person-years), although data are limited and the CIs were wide and overlapped. Among 31 patients treated with a TKI who had myocardial infarction, 26 (84%) had at least 1 major cardiac risk factor diagnosed before the event occurred. Limitations: Patients may have been exposed to multiple TKIs. Data on second-and third-generation TKIs were limited. Conclusion: An increased risk for arterial and venous vascular events was seen in patients with CML treated with a TKI. Further study is needed to determine whether the risk for myocardial infarction increases with second-generation drugs.

Publishing year

2016-08-02

Language

English

Pages

161-166

Publication/Series

Annals of Internal Medicine

Volume

165

Issue

3

Document type

Journal article

Publisher

American College of Physicians

Topic

  • Cardiac and Cardiovascular Systems
  • Cancer and Oncology

Status

Published

ISBN/ISSN/Other

  • ISSN: 0003-4819