Cardiovascular Events throughout the Disease Course in Chronic Myeloid Leukaemia Patients Treated with Tyrosine Kinase Inhibitors—A Single-Centre Retrospective Study

Abstract

Introduction. Cardiovascular risk factors, pre-existing comorbidities, molecular factors, and the direct effects of second- and third-generation BCR-ABL1 tyrosine kinase inhibitors on the vascular endothelium contribute to the progression of cardiovascular (CV) events, especially atherothrombotic conditions. The study objective was to evaluate comorbidities, the cardiovascular risk profile, and events throughout the chronic myeloid leukaemia disease course. Methods. Retrospective data from adults who experienced haematology treatment at a single centre were continuously updated and followed throughout the disease course. A total of 43 subjects conforming with the inclusion and exclusion criteria of the study protocol were finally recruited. The median disease course was 77.0 ± 17.5 months. Statistical analyses were performed. Results. More than three CV risk factors were identified in 41.9% of cases. Almost half of the cases had relevant comorbidities (Charlson Comorbidity Index (CCI) ≥ 4), and no statistically significant comorbidities were found when comparing the tyrosine kinase inhibitor (TKI) treatment subgroups (p = 0.53). The patients at high and very high CV risk, according to Systematic Coronary Risk Evaluation (SCORE) risk classification, had 75.0% CV events (12/22 patients), p = 0.45. Throughout the disease course, 19 cardiovascular events were reported in 37.2% patients (13 males/3 females, p < 0.03). Conclusion. To the best of our knowledge, this is the first study exploring cardiovascular risk factors in Romanian chronic myeloid leukaemia patients. This study reinforces the need for close long-term follow-up that should be performed by a multidisciplinary team. The target should be not only the disease and specific drug-related toxicities but, also, the identification of cardiovascular and metabolic risk factors before the commencement of and throughout TKI therapy.

Risk prediction of Metabolic and Cardio-Cerebrovascular Diseases in Myeloid Leukaemia: A meta-analysis

“…Patients with a high or very high CV risk experienced 75.0 percent (12/22 patients) of CV events. Cardiovascular events were documented in 37.2 percent of patients (13 males/3 females) throughout the disease (Varga, A., Tilea, I., Petra,et al, 2020).…”

Coronary Artery Disease and Cancer: Treatment and Prognosis Regarding Gender Differences

“…Multiple myeloma. TKI therapy resulted in progression of coronary artery disease and ACS [ 77 ]. However, the risk of cardiovascular events is higher with second- (dasatinib, nilotinib, or bosutinib) and third- (ponatinib) generation TKIs than with imatinib, the first-generation TKI.…”

Cardiovascular events and atherogenic lipid profile in chronic myeloid leukemia patients treated with nilotinib versus imatinib

“…The introduction of Bcr-Abl tyrosine kinase inhibitors (TKI), namely imatinib, dasatinib, nilotinib, bosutinib and ponatinib, in clinical practice has signifi cantly improved the prognosis of chronic myeloid leukemia (CML) patients leading to the life expectancy comparable to the normal population (1). Despite successful results achieved with fi rst-generation TKI imatinib, in nearly one-third of CML patients treatment must be discontinued, because of the intolerance or the resistance to therapy (2).…”