The effect of imatinib and nilotinib on blood calcium and blood potassium levels in chronic myeloid leukemia patient: a literature review

Prenggono, Muhammad Darwin; Yasmina, Alfi; Ariyah, Misna; Wanahari, Tenri Ashari; Hasrianti, Nuvita

doi:10.4081/oncol.2021.547

Cited by 2 publications

(4 citation statements)

References 32 publications

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“…29 A previous study indicated that Imatinib and Nilotinib acted on both the BCR-ABL1 gene and the platelet derived growth factor which may cause kidney disorders and affect blood potassium levels. 36 A retrospective study by Marcolino et al, (2011), included 100 CML in chronic phase (CML-CP) patients, and another study by Yilmaz et al, (2015) included 253 patients with CML-CP treated with Imatinib, reported that the patient's blood potassium level was not increased. 37,38 In China, a study by Wang et al, (2015) reported that the decrease in blood potassium levels of all grades was more prevalent in CML-CP patients treated with Imatinib (50%) compared to Nilotinib (21.1%).…”

Section: Discussionmentioning

confidence: 99%

Kinetic of liver enzymes and serum electrolytes in HCV, HBV, and HIV negative chronic phase chronic myeloid leukemia patients treated with imatinib or nilotinib

Hammed

Nafady

Mohamed

et al. 2023

EJI

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The outcome for chronic phase (CP) chronic myeloid leukemia (CML) patients was changed dramatically since the introduction of tyrosine kinase inhibitor (TKI) therapy. This study intended to evaluate side effects of TK Imatinib or Nilotinib on liver enzymes and serum electrolytes in relation to hematologic and molecular response in HCV-, HBV-, and HIV-, CP-CML patients. The study was a quasi-experimental pre-post single group design, included 38 HCV-, HBV-, and HIV-newly diagnosed Philadelphia positive CP-CML patients with normal hepatic and renal function. They were divided equally into two groups, 19 received Nilotinib, and 19 received Imatinib. Hematologic, BCR-ABL gene expression by RT-PCR, electrolytes and liver enzymes were measured at baseline and after 6 months of treatment. Patients age ranged between 20 and 62 years. Anemic manifestations represented the highest rate (n=23, 60.5%). The mean WBCs count was significantly reduced after treatment (p<0.001). The WBCs count was significantly reduced in the Nilotinib group than the Imatinib group (97% and 94%, respectively, p=0.049). The mean hemoglobin level was significantly increased after treatment (p=0.010). The mean platelet level did not change over the treatment period. The mean AST, ALT, and ALP levels were significantly increased after treatment, (p=0.014, p=0.002, and p=0.047, respectively). The ALP level was significantly increased in both groups (p=0.001). The mean sodium potassium, phosphorous, and calcium level was not changed over the treatment period. The mean BCR-ABL gene expression was sharply decreased after treatment (p<0.001). A higher reduction was observed in the Nilotinib group (99%) than the Imatinib group (91.5%) (p=0.025). Imatinib resulted in rise of AST and ALP levels than Nilotinib, while both had the same effect on the ALT level. Higher reduction in BCR-ABL gene expression was achieved by Nilotinib. Nilotinib and Imatinib did not affect serum levels of sodium, potassium, phosphorous, or calcium.

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Section: Discussionmentioning

confidence: 99%

Kinetic of liver enzymes and serum electrolytes in HCV, HBV, and HIV negative chronic phase chronic myeloid leukemia patients treated with imatinib or nilotinib

Hammed

Nafady

Mohamed

et al. 2023

EJI

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“…Variants in either the alpha or beta PDGFR might be an important area to investigate relative to electrolyte imbalances that occur in some patients, as a review by Prenggono et al concluded [38]. They observed that blood calcium and potassium levels tend to decrease in some patients treated with imatinib and postulated that, for potassium, this could be due to the role played by the PDGFR in kidney physiology, where it is needed for renal tubular regeneration.…”

Section: Additional Considerations Impacting Patient Responsementioning

confidence: 99%

“…The story of hypocalcemia is less clear. Calcium levels in patients taking imatinib range from the lower normal values to hypocalcemia but no clear explanation for this has been established [38]. These trends may be of particular importance in patients who already suffer from renal and/or cardiac issues.…”

Section: Additional Considerations Impacting Patient Responsementioning

confidence: 99%

“…This is in contrast to imatinib, which inhibits both PDGFR-α and PDGFR-β. This difference is thought to be why potassium levels tend to decrease by a lesser degree in patients taking nilotinib, than in those taking imatinib [38]. Since imatinib has been shown to have functional efficacy correlated with its activity against PDGFR-B, it is reasonable to suspect that there are similar effects with nilotinib [39].…”

Section: Transportersmentioning

confidence: 99%

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Current Progress on the Influence Human Genetics Has on the Efficacy of Tyrosine Kinase Inhibitors Used to Treat Chronic Myeloid Leukemia

Prakash,

Enkemann

2024

Cureus

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The use of tyrosine kinase inhibitors (TKIs) has become the mainstay of treatment in patients suffering from chronic myeloid leukemia (CML), an adult leukemia caused by a reciprocal translocation between chromosomes 9 and 22, which creates an oncogene resulting in a myeloproliferative neoplasm. These drugs function by inhibiting the ATP-binding site on the fusion oncoprotein and subsequently halting proliferative activity. The goal of this work is to investigate the current state of research into genetic factors that influence the efficacy of four FDA-approved TKIs used to treat CML. This overview attempts to identify genetic criteria that could be considered when choosing one drug over the others and to identify where more research is needed. Our results suggest that the usual liver enzymes impacting patient response may not be a major factor affecting the efficacy of imatinib, nilotinib, and bosutinib, and yet, that is where most of the past research has focused. More research is warranted on the impact that human polymorphisms of the CYP enzymes have on dasatinib. The impact of polymorphisms in UGT1A1 should be investigated thoroughly in other TKIs, not only nilotinib. The role of influx and efflux transporters has been inconsistent thus far, possibly due to failures to account for the multiple proteins that can transport TKIs and the impact that tumors have on transporter expression. Because physicians cannot currently use a patient's genetic profile to better target their treatment with TKIs, it is critical that more research be conducted on auxiliary pathways or off-target binding effects to generate new leads for further study. Hopefully, new avenues of research will help explain treatment failures and improve patient outcomes.

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The effect of imatinib and nilotinib on blood calcium and blood potassium levels in chronic myeloid leukemia patient: a literature review

Cited by 2 publications

References 32 publications

Kinetic of liver enzymes and serum electrolytes in HCV, HBV, and HIV negative chronic phase chronic myeloid leukemia patients treated with imatinib or nilotinib

Kinetic of liver enzymes and serum electrolytes in HCV, HBV, and HIV negative chronic phase chronic myeloid leukemia patients treated with imatinib or nilotinib

Current Progress on the Influence Human Genetics Has on the Efficacy of Tyrosine Kinase Inhibitors Used to Treat Chronic Myeloid Leukemia

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