Comparing the side effects of tyrosine kinase inhibitors for chronic myeloid leukemia patients

This study aimed to investigate the incidence of pulmonary hypertension in chronic myeloid leukemia patients treated with tyrosine kinase inhibitors.

This study concluded that treating CML patients with tyrosine kinase inhibitors can lead to mild pulmonary hypertension.

Tyrosine kinase inhibitors (TKIs) are a treatment option for chronic myeloid leukemia (CML). Tyrosine kinase is involved in cell growth and division and is found at high levels in cancer. TKIs work to block the action of tyrosine kinase and stop growth and division of cancer cells. Examples of TKIs are dasatinib (Sprycel), nilotinib (Tasigna) and imatinib (Gleevec).

Pulmonary hypertension (PH) is a rare but life-threatening side effect of TKIs. It involves high blood pressure that affects arteries in the lungs and right side of the heart. It has not been fully evaluated in patients treated with imatinib or nilotinib.

This study involved 105 patients with CML. 37 patients were treated with imatinib. 30 patients were treated with nilotinib and 38 patients were treated with dasatinib. The mean triscupid regurgitation peak gradient (TRPG) was measured. TRPG represents blood pressure in the arteries of the heart. Average readings vary from 8-20 mmHg.

The TRPG for newly diagnosed CML patients without treatment was 19.0 mmHg. The TRPG was 22.7 mmHg for the imatinib group. The TRPG was 23.1 mmHg for the nilotinib group. The TRPG was 23.4 mmHg for the dasatinib group.

9 patients had TRPG of 31 mmHg or greater. This is an indication of possible PH onset. 2.7% of patients in the imatinib group had this reading while 10% of the nilotinib group and 13.2% of the dasatinib group had these readings. 

This study concluded that treating CML patients with dasatinib, imatinib and nilotinib can lead to mild PH.

Consult your physician about different TKI options for treatment.