Long-term mortality rate for cardiovascular disease in 656 chronic myeloid leukaemia patients treated with second- and third-generation tyrosine kinase inhibitors

Int J Cardiol. 2020 Feb 15;301:163-166. doi: 10.1016/j.ijcard.2019.10.036. Epub 2019 Oct 24.

Abstract

Background: Limited information is available regarding the rate of long-term cardiovascular (CV) mortality in chronic myeloid leukaemia (CML) patients treated with second- and third-generation tyrosine kinase inhibitors (2ndG/3rdG TKIs) in the real-life practice.

Methods: We identified 656 consecutive CML patients treated with nilotinib, dasatinib, bosutinib and ponatinib.

Results: The 15-year CV-mortality free survival was 93 ± 2.8%. Age ≥65 years (p = 0.005) and a positive history of CV disease (p = 0.04) were significantly associated with a lower CV-mortality free survival. CV disease accounted for 16.5% and 5% of potential years of life lost (PYLL) in male and female patients, respectively. The standard mortality ratio (SMR) following ischemic heart disease (IHD) was 3.9 in males and 3.8 in female patients, meaning an excess of IHD deaths observed, in comparison with the population of control.

Conclusion: Prevention strategies based on CV risk factors, in particular in those patients with a previous history of CV disease, should be considered.

Keywords: Cardiovascular toxicity; Chronic myeloid leuk; Ischemic heart disease; TKI; a; emia.

MeSH terms

  • Aged
  • Aniline Compounds* / administration & dosage
  • Aniline Compounds* / adverse effects
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Cardiotoxicity* / etiology
  • Cardiotoxicity* / mortality
  • Cardiotoxicity* / prevention & control
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / mortality
  • Cardiovascular Diseases* / prevention & control
  • Dasatinib* / administration & dosage
  • Dasatinib* / adverse effects
  • Female
  • Humans
  • Imidazoles* / administration & dosage
  • Imidazoles* / adverse effects
  • Italy / epidemiology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Life Expectancy
  • Long Term Adverse Effects / chemically induced
  • Long Term Adverse Effects / mortality
  • Male
  • Mortality
  • Nitriles* / administration & dosage
  • Nitriles* / adverse effects
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects
  • Pyridazines* / administration & dosage
  • Pyridazines* / adverse effects
  • Pyrimidines* / administration & dosage
  • Pyrimidines* / adverse effects
  • Quinolines* / administration & dosage
  • Quinolines* / adverse effects
  • Risk Adjustment / methods

Substances

  • Aniline Compounds
  • Antineoplastic Agents
  • Imidazoles
  • Nitriles
  • Protein Kinase Inhibitors
  • Pyridazines
  • Pyrimidines
  • Quinolines
  • ponatinib
  • bosutinib
  • nilotinib
  • Dasatinib