The Effect of Comorbidities on the Choice of Tyrosine Kinase Inhibitors in Patients with Chronic Myeloid Leukemia

Saydam, Güray; Ali, Rıdvan; Demir, Ahmet Muzaffer; Eşkazan, Ahmet Emre; Güvenç, Birol; Haznedaroğlu, İbrahim C.; Ozcan, Mehmet Ali; Salim, Ozan; Sönmez, Mehmet; Tuğlular, Ayşe Tülin; Turğut, Mehmet; Ünal, Ali; Aver, Birkan; Bozkurt, Sirac; Ozdengulsun, Begum; İlhan, Osman

doi:10.2217/ijh-2021-0010

Cited by 9 publications

(4 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These comorbidities not only increase the risk of side effects such as arterio-occlusive events ( 88 ), but are now also the leading cause of death in CML patients treated with TKIs ( 89 ). Since comorbidities influence the choice/side effects of TKIs, they have a significant impact on overall survival ( 89 , 90 ). However, studies with large numbers of cases and multi-year study durations are needed to make meaningful conclusions about the effects of physical activity on mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Preferences also differed with regard to the training location depending on the studied cohort. While 47% of CML patients stated that they preferred to exercise at home, the literature reports between 20% and 83% ( 72 , 74 , 82 , 83 , 89 , 90 ). While 80% of patients with incurable cancer prefer to exercise alone and unsupervised ( 93 ), other patient cohorts, including head and neck cancer patients ( 84 ) and cancer survivors ( 72 ) prefer supervised exercise programs.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97)

Hollenbach,

Rogahn,

le Coutre

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

BackgroundTyrosine kinase inhibitors (TKIs) have significantly lowered mortality of chronic myeloid leukemia (CML) patients adjusting life expectancy to that of the standard population. However, CML and its treatment with TKIs causes a high disease burden. Physical exercise (PE) could be a non-pharmacological approach to reducing these and improving quality of life.PurposeThe aim of this study was to determine the individual disease burden as well as PE preferences of CML patients and to deduce thereof specific PE recommendations.MethodsThis multicenter survey was conducted in cooperation with the LeukaNET/Leukemia-patient network including CML patients aged ≥18 years (German Registry of Clinical Trials, DRKS00023698). The severity of selected symptoms was assessed using the adapted Myeloproliferative Neoplasms Symptom Assessment Form: 0 (absent), 1–30 (mild), 31–70 (moderate), or 71–100 (severe). Information about patients’ PE needs and preferences depending on their motivation was recorded.ResultsA total of 212 questionnaires were analyzed (52% female, median age 54 years). The prevalence of moderate-to-severe symptoms was 49% for fatigue, 40% for musculoskeletal pain, and 37% for concentration problems. Other commonly reported symptoms included skin reactions (42%) and weight gain (24%). The proportion of overweight/obese patients was 52%. Half of all respondents requested more information regarding PE. Patients with CML preferred individual training (82%), located outdoors (71%), at home (47%), or in an indoor swimming pool (31%). Regarding the training frequency, sports-inactive patients preferred a frequency of 1–2 training sessions per week, whereas sports-active patients preferred 3–4 sessions per week (p <0.001). Sports-inactive patients preferred a training time of 15–45 minutes, while sports-active patients preferred 30–60 minutes (p = 0.002). Subsequently, PE recommendations were developed for patients with CML. Combined resistance and endurance training (moderate intensity twice per week for 30 minutes) was recommended for beginners. Obese patients should prioritize joint-relieving sports. To reduce the risk of skin reactions, direct sunlight and possibly water sports should be avoided, and UV protection should be used.ConclusionCounseling and motivation of CML patients to be physically active should be part of the standard of care as well as support for implementation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97)

Hollenbach,

Rogahn,

le Coutre

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Patient age is an important factor when selecting a TKI as the rate of relevant comorbidities tends to increase, and patients may present contraindications to certain treatments and may be at a higher risk for intolerance or more serious AEs with increasing age. 46 , 98 , 106 , 107 According to a retrospective study of commercially insured and Medicare enrollees with CML, older age (≥55 years) is associated with multiorgan system AEs with TKIs. 108 Trial data supports a similar concern; in the DASISION trial, median age of patients who developed a pleural effusion with dasatinib was 15 years older than those who did not.…”

Section: Considerations For Patient Selection For Asciminibmentioning

confidence: 99%

Asciminib in the Treatment of Philadelphia Chromosome-Positive Chronic Myeloid Leukemia: Focus on Patient Selection and Outcomes

Hijiya,

Mauro

2023

CMAR

View full text Add to dashboard Cite

Tyrosine kinase inhibitors (TKIs) have significantly changed the treatment of chronic myeloid leukemia (CML) and improved outcomes for patients with CML in chronic phase (CML-CP) and accelerated phase (AP). Now armed with numerous effective therapeutic options, clinicians must consider various patient- and disease-specific factors when selecting the most appropriate TKI across lines of therapy. While most patients with CML expected to have a near-normal life expectancy due to the success of TKIs, emphasis has expanded beyond response and survival to include factors like quality of life, tolerability, and long-term toxicity management. Importantly, a subset of patients can achieve sustained deep molecular response and can attain treatment-free remission. Despite these successes, unmet needs remain related to CML treatment, including the persistent challenge of treatment resistance and intolerance, broadening treatment options for patients with resistance mutations or serious comorbidities, and focus on specific populations such as children and young adults. In particular, the only previously available treatments for patients with CML-CP with the T315I mutation were ponatinib, olverembatinib (exclusively approved for use in China at the time of this writing), omacetaxine, and hematopoietic stem cell transplantation. Asciminib has entered the CML treatment landscape as a new option for adult patients with CML-CP who have received ≥2 prior TKIs or those with the T315I mutation. Asciminib’s unique mechanism of action, Specifically Targeting the ABL Myristoyl Pocket, sets it apart from traditional adenosine triphosphate-competitive TKIs. While asciminib may overcome unmet needs for patients with CML-CP and continues to be studied in other novel settings, guidance on how to integrate asciminib in treatment algorithms is needed. This review focuses on clinical data and how asciminib can overcome current unmet needs, discusses how to individualize patient selection, and highlights future directions to investigate asciminib in earlier lines of therapy and in children and adolescents.

show abstract

“…Consequently, the third-generation ponatinib was developed and approved in patients with BCR::ABL1T315I mutation ( 6 , 9 ). Table 1 summarizes the general characteristics of TKIs ( 1–3 , 8 , 10 ). The three additional third-generation agents have been investigated in TKI-resistant CML and included olverembatinib, asciminib, and vodobatinib.…”

Section: Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

A practical guide to managing cardiopulmonary toxicities of tyrosine kinase inhibitors in chronic myeloid leukemia

et al. 2023

View full text Add to dashboard Cite

Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML) but their use was associated with a range of serious cardiopulmonary toxicities including vascular adverse events, QT prolongation, heart failure, pleural effusion, and pulmonary arterial hypertension. Dedicated clinical management guidelines for TKI-induced toxicities are not available. This review aims to discuss TKI-associated cardiopulmonary toxicities and proposes a practical guide for their management.

show abstract

The Effect of Comorbidities on the Choice of Tyrosine Kinase Inhibitors in Patients with Chronic Myeloid Leukemia

Cited by 9 publications

References 55 publications

Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97)

Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97)

Asciminib in the Treatment of Philadelphia Chromosome-Positive Chronic Myeloid Leukemia: Focus on Patient Selection and Outcomes

A practical guide to managing cardiopulmonary toxicities of tyrosine kinase inhibitors in chronic myeloid leukemia

Contact Info

Product

Resources

About