Effects of Intermittent Fasting on Response to Tyrosine Kinase Inhibitors (TKIs) in Patients With Chronic Myeloid Leukemia: An Outcome of European LeukemiaNet Project

Abstract

The overall survival of patients with Chronic Myeloid Leukemia (CML) treated by using tyrosine kinase inhibitors (TKIs) is very close to that of the healthy population. However, little is known about the effect of specific measures such as intermittent fasting, especially during Ramadan period. A 3-year retrospective study was conducted to evaluate the effect of fasting on patients with CML receiving TKIs by evaluating certain clinical, hematological, and molecular parameters. A total of 49 patients were eligible, with a median age of 46 years (range: 22-86), of these 36 (73.5%) were males and 13 (26.5%) were females. Twenty-seven (55%) patients are Middle Eastern, while 16 (32.7%) from the Indian subcontinent, and 6 (12.3%) Africans. Imatinib was the most common TKI; used in 25 patients (51%). The mean White blood cells (WBCs), neutrophils, and BCR-ABL were found to be reduced after fasting compared to before and during with statistical difference. The use of TKIs while fasting did not result in significant changes in hematological nor BCR-ABL levels in our study. Patients who wish to practice intermittent fasting may be reassured in this regard, yet physicians can adopt the safe trial approach, where they allow the patients to fast, but with instructions such as when to break fasting.

Ramadan Fasting in Health and Disease in 2021: A Narrative Review

“…Two studies were concerned with hematological oncology and radiotherapy. Yassin et al 54 evaluated the effect of RF on patients with chronic myeloid leukemia receiving tyrosine kinase inhibitors (TKIs) by evaluating specific clinical, hematological, and molecular parameters in a 3-year retrospective study. Forty-nine patients were included, aged 46 years, 73.5% males.…”

Patient with clinical celiac disease mimicking triple‐negative essential thrombocythemia

“…Our group is studying the unmet needs and unanswered questions in Philadelphia negative MPNs such as priapism 22 as well as unmet needs in CML such as the effects of intermittent fasting 23 and obesity 24 in response to TKIs as well as priapism. 25 …”

“…She was not on a gluten-free diet before the diagnosis. 21 Our group is studying the unmet needs and unanswered questions in Philadelphia negative MPNs such as priapism 22 as well as unmet needs in CML such as the effects of intermittent fasting 23 and obesity 24 in response to TKIs as well as priapism. 25 In conclusion, patients with suspected essential thrombocythemia (ET) who are triple-negative should be screened for celiac disease before doing more sophisticated studies such as gene sequencing or more invasive tests such as bone biopsy.…”

Dasatinib-Induced Colitis with Rectal Sparing in a Patient with Chronic Myeloid Leukemia (Chronic Phase) on Dasatinib as an Upfront Therapy: Case Report

“…After stopping dasatinib treatment, our patient was started on imatinib; pros and cons were explained, and her questions were addressed as well; we encouraged the patient for treatment adherence in case of any adherence difficulty or problem (e.g., economic factor and medication side effect) and follow-up for close monitoring and dose adjustment since it can affect the treatment success [ 9 , 10 ]. Our group is studying the unmet clinical needs in Myeloproliferative neoplasms [ 11 ] and CML like cost effective analysis for second generations TKIs when used as upfront [ 12 ], the association of tuberclosis with CML [ 13 ], the reactivation of hepatitis B with CML [ 14 ], ophthalmic manifestations as initial presentation in patients with CML [ 15 ], Effects of intermittent fasting on CML [ 16 ], autoimmune hemolytic anemia and its association with different therapies in CML [ 17 ], priapism [ 18 , 19 ] and male fertility [ 20 ], as well as obesity [ 21 ] and obesity related surgeries in patients with CML [ 22 ].…”