Pulmonary hypertension in patients with chronic myeloid leukemia

Song, Ik‐Chan; Yeon, Sang-Hoon; Lee, Myeong-Won; Ryu, Hyewon; Yun, Hwan‐Jung; Sun, Byung Joo; Park, Jae‐Hyeong; Jeong, Jin‐Ok; Jo, Deog‐Yeon

doi:10.1097/md.0000000000026975

Cited by 4 publications

(4 citation statements)

References 35 publications

(88 reference statements)

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“…Consistent with previous reports ( 6 , 16 ), we found that increasing age was significantly associated with PH. In the current study, the age of the patients was 10–15 years younger than those of the studies from western countries ( 17 , 18 ).…”

Section: Discussionsupporting

confidence: 93%

“…Nilotinib has been reported to injure vascular endothelial cells by direct pro-atherogenic and anti-angiogenic effects and might be associated with the cumulative effect on the onset of PH ( 20 ). Consistent with previous studies, PH was more likely to occur in elderly patients who received dasatinib therapy ( 6 , 16 ). Understandably, patients with cardiopulmonary comorbidities were prone to develop a high probability of PH when receiving dasatinib therapy.…”

Section: Discussionsupporting

confidence: 90%

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Variables associated with pulmonary hypertension screened by echocardiography in chronic myeloid leukemia patients on dasatinib therapy

Jin¹,

Yang²,

Yu³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPulmonary hypertension (PH) is a rare but life-threatening adverse event (AE) of dasatinib, but the associated variables are not clear. This study aimed to explore the variables associated with PH by echocardiography in patients with chronic myeloid leukemia in the chronic phase (CML-CP) receiving dasatinib therapy.MethodsEchocardiography was performed to estimate the probability of PH and pulmonary artery systolic pressure (PASP). Binary logistic analysis and Fine–Gray hazard model were used to identify the variables associated with PH by using cross-sectional and longitudinal data.ResultsAmong the 243 patients in the cross-sectional dataset, with a median dasatinib therapy duration of 27 months, 30 (12.3%) were classified as having a high probability of PH. Increasing age (OR = 1.7, p = 0.002; OR = 1.5, p = 0.003) and pericardial effusion (OR = 4.3, p = 0.004; OR = 3.2, p = 0.014) were significantly associated with a high probability of PH and PASP ≥ 40 mmHg, respectively. Among the 161 patients in the longitudinal dataset, the 3-year cumulative incidences of a high probability of PH and PASP ≥ 40 mmHg were 9.3% and 22.1%, respectively. Pericardial effusion (HR = 3.8, p = 0.005) and cardiopulmonary comorbidities (HR = 3.2, p = 0.021) were significantly associated with a high probability of PH; increasing age (HR = 1.5, p < 0.001) and dasatinib as ≥ 3rd-line therapy (p = 0.032; 2nd-line vs. 1st-line, HR = 2.0, p = 0.200; ≥ 3rd-line vs. 1st-line, HR = 3.4, p = 0.047) were significantly associated with PASP ≥ 40 mmHg.ConclusionIncreasing age, pericardial effusion, cardiopulmonary comorbidities, and dasatinib as ≥ 3rd-line TKI therapy were associated with PH in the patients with CML-CP on dasatinib therapy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Variables associated with pulmonary hypertension screened by echocardiography in chronic myeloid leukemia patients on dasatinib therapy

Jin¹,

Yang²,

Yu³

et al. 2022

Front. Cardiovasc. Med.

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show abstract

“…[8] Pulmonary hypertension and life-threatening cardiac arrhythmias can occur. [9,10] Pulmonary toxicities (e.g., pleural effusion <1%) are rare, as reported in previous clinical trials. [11,12] Previous case reports showed that nilotinib can successfully substitute imatinib in patients with imatinib-induced ILD.…”

Section: Introductionmentioning

confidence: 58%

“…Most commonly reported drug-related adverse events are rash, pruritus and gastrointestinal upset [8] . Pulmonary hypertension and life-threatening cardiac arrhythmias can occur [9,10] . Pulmonary toxicities (e.g., pleural effusion <1%) are rare, as reported in previous clinical trials [11,12] .…”

Section: Introductionmentioning

confidence: 86%

A case report of nilotinib-induced irreversible interstitial lung disease

et al. 2022

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Rationale: Nilotinib is a second line tyrosine kinase inhibitor to treat patients with chronic myeloid leukemia after imatinib resistance or intolerance. Drug related pulmonary complication is known to be rare. We discuss a case of nilotinib-induced interstitial lung disease presenting with nonspecific interstitial pneumonia on the unilateral lung. Patient concerns: A 46-year-old man with chronic-phase chronic myeloid leukemia presented with cough and weight loss for 2 months. He had been treated with nilotinib for 52 months. Diagnosis: Computed tomography scan showed right lung dominant consolidations, ground glass opacities and traction bronchiectasis. Bronchoalveolar lavage fluid analysis revealed no evidence of infection or malignancy. Surgical lung biopsy specimen was consistent with fibrosing nonspecific interstitial pneumonia. The patient was diagnosed with nilotinib induced interstitial lung disease. Interventions: Corticosteroid treatment was initiated with prednisolone (50 mg daily) and slowly tapered down for 2 months. Outcomes: Cough improved after the course of corticosteroid treatment. However, fibrotic lung lesions persisted. Reinitiation of nilotinib resulted in the worsening of lung lesions. Lessons: We report a case of irreversible interstitial lung disease that caused by nilotinib. Clinicians should have suspicion of this potential pulmonary complication in patients with respiratory symptoms and abnormal radiologic findings during nilotinib treatment, albeit rarely.

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Dasatinib/imatinib/nilotinib

2021

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Pulmonary hypertension in patients with chronic myeloid leukemia

Abstract: Supplemental Digital Content is available in the text

Cited by 4 publications

References 35 publications

Variables associated with pulmonary hypertension screened by echocardiography in chronic myeloid leukemia patients on dasatinib therapy

Variables associated with pulmonary hypertension screened by echocardiography in chronic myeloid leukemia patients on dasatinib therapy

A case report of nilotinib-induced irreversible interstitial lung disease

Dasatinib/imatinib/nilotinib

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