Key result
TKI therapy in CML patients is linked to a ~37% incidence of cardiovascular events.
Why the study?
Cardiovascular risk factors, comorbidities, molecular factors, and tyrosine kinase inhibitor vascular endothelial effects contribute to cardiovascular events, prompting evaluation of CV risk and events throughout the chronic myeloid leukaemia disease course.
Cohort (n=43)
No
In a Romanian cohort of chronic myeloid leukaemia patients treated with TKIs, over a third experienced cardiovascular events, highlighting the need for multidisciplinary cardio-oncology follow-up.
Answers are grounded in this paper and cite their sources.
Associates higher CV events with male sex in TKI-treated CML; leaves open validation in prospective cohorts before guiding care.
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.
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Varga et al. (2020) conducted a cohort in Chronic myeloid leukaemia (n=43). Tyrosine kinase inhibitors was evaluated on Cardiovascular and atherothrombotic events. Tyrosine kinase inhibitor therapy in chronic myeloid leukaemia patients was associated with a 37.2% incidence of cardiovascular or atherothrombotic events over a median follow-up of 77 months.
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