Chronic Myeloid Leukemia Coverage from Every Angle
Advertisement
Advertisement

Cardiovascular Health Considerations When Using Tyrosine Kinase Inhibitors

By: Joseph Fanelli
Posted: Friday, May 4, 2018

The success of treatment with tyrosine kinase inhibitors (TKIs) has improved prognosis and extended survival for many patients with chronic myeloid leukemia (CML). But with later-generation TKIs being associated with cardiovascular health complications, a need for cardiovascular risk assessment for patients with CML is needed, according to a review published in the American Society of Hematology Education Program.

“The realization that subsequent-generation TKIs may increase [cardiovascular] disease risk adds further urgency to development of ways to mitigate [cardiovascular] risk in this population,” stated Michael J. Mauro, MD, of the Memorial Sloan Kettering Cancer Center, and colleagues.

Researchers reviewed imatinib and later-generation TKIs—dasatinib, nilotinib, ponatinib, and bosutinib—in regard to the drugs’ effect on cardiovascular health. Cardiovascular assessment, blood pressure check, electrocardiography, and a 3- to 6-month cardiovascular follow-up were recommended with each TKI, and various assessments were outlined by the researchers for high-risk patients.

Considering the number of TKIs available, cardiovascular health should be considered “for every patient with CML,” the investigators recommended. To determine the clinical management of high- and low-risk patients with CML, they developed an algorithm. Patients with risk factors ≥ 1 or an existing cardiovascular disease are considered high–cardiovascular risk patients. Of that group, imatinib, dasatinib, and bosutinib are considered relatively low–cardiovascular risk therapies; for patients at high cardiovascular risk who are treated with nilotinib and ponatinib, screening for cardiovascular disease should occur prior to treatment, with monitoring performed every 3 to 6 months and drug modification considered when needed.



By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.