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Chronic Myeloproliferative Neoplasias

Peripheral artery occlusive disease in chronic phase chronic myeloid leukemia patients treated with nilotinib or imatinib

Leukemia volume 27, pages 1316–1321 (2013)Cite this article

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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.

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Acknowledgements

FEN thanks Madeleine Etienne CRA for data collection.

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Authors and Affiliations

  1. Medizinische Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie, Charité—Universitätsmedizin Berlin, Berlin, Germany

    T D Kim, M Schwarz, P Grille, B Dörken & P D le Coutre

  2. Service des Maladies du Sang, Hôpital Saint-Louis, AP-HP, Paris, France

    D Rea & H Dombret

  3. Hématologie Clinique 1G, Centre Hospitalier Lyon Sud, Pierre Bénite, France

    F E Nicolini & H Labussière

  4. Institute of Hematology and Medical Oncology Seràgnoli, Bologna University Hospital, Bologna, Italy, and GIMEMA CML Working Party

    G Rosti

  5. Department of Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy

    L Levato

  6. CRF, National University of Ireland Galway and Trinity College Dublin, Dublin, Ireland

    F J Giles

  7. Service de Medecine Vasculaire, Hopital Europeen Georges Pompidou, AP-HP, Paris, France

    T Mirault

  8. Medizinische Klinik m.S. Kardiologie, Charité—Universitätsmedizin Berlin, Berlin, Germany

    R Lindhorst, W Haverkamp & I Buschmann

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  1. T D Kim
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  2. D Rea
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  3. M Schwarz
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  7. L Levato
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  8. F J Giles
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  10. T Mirault
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  11. H Labussière
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  15. B Dörken
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  16. P D le Coutre
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Correspondence to P D le Coutre.

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Competing interests

TDK, MS, PG, LL, HD, TM, HL, RL, WH, IB and BD declare no conflict of interest. DR received honoraria from Teva, Novartis and BMS. FEN was a consultant for Novartis, Ariad and Teva. He received lecture fees from BMS, Novartis, Ariad and Teva and received advisory board honoraria from Novartis, Ariad, Teva and Pfizer. GR received honoraria from Novartis, BMS, Pfizer and Roche. FJG is a consultant for and received research funding from Novartis. PDLC received honoraria from Novartis, BMS, Pfizer and Ariad. He also received research funding from Novartis.

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Kim, T., Rea, D., Schwarz, M. et al. Peripheral artery occlusive disease in chronic phase chronic myeloid leukemia patients treated with nilotinib or imatinib. Leukemia 27, 1316–1321 (2013). https://doi.org/10.1038/leu.2013.70

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