New prospects for the management of cardiovascular effects of tyrosine kinase inhibitors in patients with chronic myeloid leukemia

The use of tyrosine kinase inhibitors (TKIs) for the treatment of chronic myeloid leukemia has significantly altered the prognosis of this disease, enabling close to normal life expectancy.Despite their undeniable benefits, the use of TKIs is associated with an increased risk of side effects on the...

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Bibliographic Details
Main Authors: Ana G. Almeida, António Almeida, Teresa Melo, Lurdes Guerra, Luís Lopes, Patrícia Ribeiro, Marta Duarte, Alexandra Mota, Ricardo Fontes-Carvalho
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:Revista Portuguesa de Cardiologia (English Edition)
Online Access:http://www.sciencedirect.com/science/article/pii/S2174204919300054
Description
Summary:The use of tyrosine kinase inhibitors (TKIs) for the treatment of chronic myeloid leukemia has significantly altered the prognosis of this disease, enabling close to normal life expectancy.Despite their undeniable benefits, the use of TKIs is associated with an increased risk of side effects on the cardiovascular system, particularly of atherothrombotic events. It is therefore necessary to understand and prevent the adverse effects of these drugs, in order to enable antileukemic therapy to continue and to minimize patients’ toxic exposure.This multidisciplinary consensus document, developed through a collaboration between hematologists and cardiologists, aims to review the cardiovascular toxicity associated with various TKIs and to establish recommendations for the follow-up of these patients. Measures are also proposed for the assessment and reduction of cardiovascular risk in these patients and referral criteria, and relevant drug interactions are discussed. Resumo: O uso dos inibidores da tirosina cínase (ITC) para o tratamento da leucemia mieloide crónica alterou significativamente o prognóstico dessa doença e permitiu uma esperança de vida praticamente normal. Apesar dos seus inegáveis benefícios, o uso dos ITC está associado a um aumento do risco de efeitos colaterais sobre o sistema cardiovascular, nomeadamente no risco de eventos aterotrombóticos. Torna-se por isso necessário conhecer e prevenir os efeitos adversos desses fármacos de modo a permitir a continuação da terapêutica antileucémica e minimizar a toxidade para os doentes. Este documento multidisciplinar, elaborado através de uma colaboração entre hematologistas e cardiologistas de vários serviços hospitalares portugueses, tem por objetivo rever a toxidade cardiovascular associada aos vários ITCs e estabelecer sugestões para o seguimento desses doentes. São ainda propostas medidas para a avaliação e redução do risco cardiovascular desses doentes, critérios de referenciação e discutidas interações medicamentosas relevantes. Keywords: Cardio-oncology, Chemotherapy, Tyrosine kinase inhibitors, Cardiotoxicity, Chronic myeloid leukemia, Palavras-chave: Cardio-oncologia, Quimioterapia, Inibidores da tirosinacinase, Cardiotoxicidade, Leucemia mieloide crónica
ISSN:2174-2049