title: Real-life comparison of severe vascular events and other non-hematological complications in patients with chronic myeloid leukemia undergoing second-line nilotinib or dasatinib treatment.
abstract: We retrospectively analyzed the rates of significant non-hematological adverse events (AEs) in 105 patients with chronic myeloid leukemia (CML) treated with second-generation tyrosine kinase inhibitor (TKIs) dasatinib or nilotinib used as second-line therapy in Polish tertiary care centers. Our analysis revealed that in a "real life setting," nearly half of patients with CML on second-generation TKIs suffer from therapy complications. Grade 2-5 non-hematological AEs were observed in 40% of patients treated with nilotinib and in 42% treated with dasatinib (p=0.83). Severe vascular events including peripheral artery occlusive disease (PAOD) occurred in 11% of patients on nilotinib and 4% on dasatinib (p=0.16). Pleural effusion occurred more often in the dasatinib group (26%) than in the nilotinib group (2%) (p=0.003). Importantly, most AEs occurred late, after more than 1 year of treatment. Since AEs are most often the reason for poor therapy compliance, careful monitoring of tolerability is crucial for an optimal treatment response in CML.
authors.affiliation: a Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Gora-Tybor
authors.affiliation: b Department and Clinic of Hematology , Blood Neoplasms, and Bone Marrow Transplantation , Wroclaw , Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Medras
authors.affiliation: c Department of Hematology , Nicolaus Copernicus Hospital , Torun , Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Calbecka
authors.affiliation: a Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kolkowska-Leśniak
authors.affiliation: d Department of Hematology , Holycross Cancer Center , Kielce , Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Ponikowska-Szyba
authors.affiliation: e Department of Hematology , Medical University of Lodz , Lodz , Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Robak
authors.affiliation: a Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Jamroziak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000069439:Dasatinib / Q000009:adverse effects* / Q000627:therapeutic use; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology*; D010996:Pleural Effusion / Q000209:etiology; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D019233:Retreatment; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; C498826:nilotinib; D000069439:Dasatinib
keywords: CML; PAOD; dasatinib; nilotinib; non-hematological complication; vascular complication