Peripheral arterial occlusive disease in chronic myeloid leukemia treated with TKI therapy

This study compared the rates of peripheral arterial occlusive disease (PAOD) in chronic myeloid leukemia (CML) patients treated with different therapies. The authors concluded that nilotinib (Tasigna) was associated with higher rates of PAOD than other treatments.

Tyrosine kinase inhibitors (TKIs) are now the standard treatment for most patients with chronic phase CML. TKI therapies block a protein that leads to cancer cell growth and spread. These therapies, however, have also been associated with changes to the structure of blood vessels.

PAOD is a condition in which the blood vessels to the arms and legs narrow. This can reduce blood flow to the limbs. The risk of PAOD can increase with age and other factors, such as high blood pressure, high cholesterol (a fat that can build up in blood vessels), and diabetes. TKI therapies have also been associated with PAOD. It is not clear whether certain TKIs increase the risk more than others.

This study compared the rates of PAOD in patients treated with two different TKI therapies or other treatments.

The records of 2390 patients who took part in previous clinical trials were examined. 533 patients were treated with a non-TKI treatment, interferon (group 1). 566 patients were treated with nilotinib (group 2). 1301 patients were treated with imatinib (Gleevac, group 3). Patients were followed for more than 3 years.

Twelve patients overall experienced PAOD. Of these, 3 were from group 1 (0.6%), 7 were from group 2 (1.3%), and 2 were from group 3 (0.2%). 92% of these patients had known risk factors for PAOD.

After taking risk factors into account, there was no difference in the odds of PAOD between group 1 and group 2. Patients in group 2 had a 14.6-fold increase in the odds of PAOD compared to group 3.

This study concluded that nilotinib was associated with higher rates of PAOD than imatinib.

This study was funded in part by Novartis, the manufacturer of nilotinib and imatinib.