title: Peripheral artery occlusive disease in chronic phase chronic myeloid leukemia patients treated with nilotinib or imatinib.
abstract: Several retrospective studies have described the clinical manifestation of peripheral artery occlusive disease (PAOD) in patients receiving nilotinib. We thus prospectively screened for PAOD in patients with chronic phase chronic myeloid leukemia (CP CML) being treated with tyrosine kinase inhibitors (TKI), including imatinib and nilotinib. One hundred and fifty-nine consecutive patients were evaluated for clinical and biochemical risk factors for cardiovascular disease. Non-invasive assessment for PAOD included determination of the ankle-brachial index (ABI) and duplex ultrasonography. A second cohort consisted of patients with clinically manifest PAOD recruited from additional collaborating centers. Pathological ABI were significantly more frequent in patients on first-line nilotinib (7 of 27; 26%) and in patients on second-line nilotinib (10 of 28; 35.7%) as compared with patients on first-line imatinib (3 of 48; 6.3%). Clinically manifest PAOD was identified in five patients, all with current or previous nilotinib exposure only. Relative risk for PAOD determined by a pathological ABI in first-line nilotinib-treated patients as compared with first-line imatinib-treated patients was 10.3. PAOD is more frequently observed in patients receiving nilotinib as compared with imatinib. Owing to the severe nature of clinically manifest PAOD, longitudinal non-invasive monitoring and careful assessment of risk factors is warranted.
authors: Medizinische Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: T D
authors: TD
authors: Kim
authors: D
authors: D
authors: Rea
authors: M
authors: M
authors: Schwarz
authors: P
authors: P
authors: Grille
authors: F E
authors: FE
authors: Nicolini
authors: G
authors: G
authors: Rosti
authors: L
authors: L
authors: Levato
authors: F J
authors: FJ
authors: Giles
authors: H
authors: H
authors: Dombret
authors: T
authors: T
authors: Mirault
authors: H
authors: H
authors: Labussière
authors: R
authors: R
authors: Lindhorst
authors: W
authors: W
authors: Haverkamp
authors: I
authors: I
authors: Buschmann
authors: B
authors: B
authors: Dörken
authors: P D
authors: PD
authors: le Coutre
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000150:complications*; D001549:Benzamides / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy*; D058729:Peripheral Arterial Disease / Q000150:complications*; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; C498826:nilotinib