Clinical characteristics of vascular adverse events and significance of peripheral artery disease as a risk factor in chronic myeloid leukemia patients treated with nilotinib

• Published in: Rinshō ketsueki Vol. 59; no. 2; p. 137
• Main Authors: Sumi, Masahiko, Sato, Keijiro, Uematsu, Nozomu, Kawaguchi, Hiroko, Shishido, Tsutomu, Kaiume, Hiroko, Takeda, Wataru, Kirihara, Takehiko, Ueki, Toshimitsu, Hiroshima, Yuki, Ueno, Mayumi, Ichikawa, Naoaki, Urasawa, Nobuyuki, Kobayashi, Hikaru
• Format: Journal Article
• Language: Japanese
• Published: Japan 2018
• Subjects: Aged; Aged, 80 and over; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Male; Middle Aged; Peripheral Arterial Disease - chemically induced; Pyrimidines - adverse effects; Pyrimidines - therapeutic use; Risk Factors; Treatment Outcome; Nilotinib; Vascular adverse events; Chronic myeloid leukemia; Ankle-brachial index
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.59.137

Vascular adverse events (VAEs) in chronic myeloid leukemia (CML) patients treated with nilotinib (NIL) has become a; however, studies on strategies to prevent VAEs remain limited. Therefore, the present study investigated VAEs in 19 CML patients treated with NIL at our hospital. The median age of the patients was 65 years and median follow-up period was 55 months after the initiation of NIL. VAEs occurred in 8 patients (peripheral artery disease (PAD), n=6; cerebral infarction (CI), n=3; coronary artery disease (CAD), n=4). The median elapsed time from the initiation of NIL to VAEs was 42 months. The 4-year cumulative incidence of VAEs was 23.5%. Majority of the patients with VAEs were smokers (P=0.074). All the six patients with PAD were diagnosed on the basis of the ankle-brachial index (ABI<0.9) in the asymptomatic phase; 4 of these patients had other VAEs (CI, n=1; CAD, n=2; CI and CAD, n=1). However, antecedent asymptomatic PAD was diagnosed even before CAD was diagnosed in two patients. Nevertheless, in cardiology, extensive studies have indicated that asymptomatic PAD is a risk factor for the development of cardiovascular events. In conclusion, for the effective management of CML patients treated with NIL, a routine screening with ABI to diagnose asymptomatic PAD may be beneficial in preventing severe VAEs.