A 62-year-old man with chronic myeloid leukemia developed nilotinib-associated vasospastic angina, which significantly improved after reducing the nilotinib dosage.
Case Report (n=1)
No
Nilotinib, a BCR-ABL tyrosine kinase inhibitor used for CML, can cause vasospastic angina, highlighting the need for vigilance regarding its vasculotoxic effects.
BACKGROUND: Nilotinib, a second-generation BCR-ABL tyrosine kinase inhibitor (TKI), is highly effective in the treatment of patients with chronic myeloid leukemia (CML), despite being more vasculotoxic than older TKIs such as imatinib. Herein, we present a case of nilotinib-associated vasospastic angina confirmed by an acetylcholine spasm provocation test. CASE PRESENTATION: A 62-year-old CML patient treated with 300 mg nilotinib twice daily complained of several episodes of rest angina and was hospitalized at our institution. Coronary angiography revealed no severe organic stenosis, and the acetylcholine spasm provocation test confirmed the diagnosis of vasospastic angina. Although treatment with a calcium channel blocker and nicorandil reduced the frequency of chest pain, angina symptoms continued to occur. At 10 months post discharge, the patient complained of increased frequency of angina; therefore, the nilotinib dosage was reduced to 150 mg twice daily. Consequently, the patient reported a significant improvement in chest symptoms. CONCLUSIONS: This case report highlights the potential vasculotoxic effects of nilotinib. Cardiologists and hematologists should be vigilant for coronary artery spasm as a possible vascular adverse event caused by nilotinib.
Maruta et al. (2021) conducted a case report in Chronic myeloid leukemia and vasospastic angina (n=1). Nilotinib was evaluated on Diagnosis and symptom improvement of vasospastic angina. A 62-year-old man with chronic myeloid leukemia developed nilotinib-associated vasospastic angina, which significantly improved after reducing the nilotinib dosage.