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Features of vascular adverse events in Japanese patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors: a retrospective study of the CML Cooperative Study Group database

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Abstract

This study investigated the incidence rate and features of vascular adverse events (VAEs) in Japanese patients with chronic myeloid leukemia (CML) who were treated with tyrosine kinase inhibitors (TKIs). The analysis included 369 CML patients in the chronic or accelerated phases, selected from the CML Cooperative Study Group database; 25 events in 23 (6.2%) of these patients were VAEs. At the time of VAE incidence, nine patients were on treatment with imatinib, 12 with nilotinib, three with dasatinib, and one with bosutinib. VAE incidence comprised 13 cases of ischemic heart disease (IHD), eight of cerebral infarction (CI), and four of peripheral arterial occlusive disease (PAOD). IHD incidence rate in the study population was higher than that in the age-matched general population, particularly in nilotinib-treated patients, while CI incidence rate was almost equivalent. Compared with the Suita score, the SCORE chart and the Framingham score risk assessment tools detected more patients with high or very high risk of VAEs. In conclusion, incidence of IHD requires closer monitoring in nilotinib-treated patients. More detailed investigations for determining the most useful tool to predict VAE incidence and long-term analysis of therapy-related VAE cases are needed for improving safety during TKI therapy.

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Authors and Affiliations

  1. Department of Hematology, Juntendo University School of Medicine, 3-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Isao Fujioka, Tomoiku Takaku & Norio Komatsu

  2. Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan

    Noriyoshi Iriyama & Yoshihiro Hatta

  3. Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan

    Michihide Tokuhira, Yuta Kimura & Masahiro Kizaki

  4. Department of Hematology, Juntendo University Nerima Hospital, Tokyo, Japan

    Eriko Sato

  5. Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan

    Maho Ishikawa & Norio Asou

  6. Department of Hematology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan

    Tomonori Nakazato

  7. Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan

    Kei-Ji Sugimoto

  8. Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan

    Hiroyuki Fujita

  9. Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan

    Tatsuya Kawaguchi

Authors
  1. Isao Fujioka
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  2. Tomoiku Takaku
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  10. Hiroyuki Fujita
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  12. Masahiro Kizaki
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  13. Yoshihiro Hatta
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  14. Norio Komatsu
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  15. Tatsuya Kawaguchi
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Corresponding author

Correspondence to Tomoiku Takaku.

Ethics declarations

The study was approved by the research ethics boards of each institution participating in the study and was conducted in accordance with the Declaration of Helsinki.

Ethical approval

For this type of study, formal consent is not required.

Conflict of interest

Author Tomoiku Takaku has received a speaker honorarium from Bristol-Myers Squibb, Novartis Pharma K.K, Pfizer Inc. Noriyoshi Iriyama has received a speaker honorarium from Bristol-Myers Squibb. Michihide Tokuhira has received a speaker honorarium from Bristol-Myers Squibb and Pfizer Inc. Tatsuya Kawaguchi has received a speaker honorarium from Novartis Pharma K.K.

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Fujioka, I., Takaku, T., Iriyama, N. et al. Features of vascular adverse events in Japanese patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors: a retrospective study of the CML Cooperative Study Group database. Ann Hematol 97, 2081–2088 (2018). https://doi.org/10.1007/s00277-018-3412-8

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