Collaborative cardiovascular management of patients with chronic myeloid leukemia on tyrosine kinase inhibitors. (June 2020)

• Record Type: Journal Article
• Authors: Kondapalli, Lavanya; Worth, Sarah; Hawi, Riem; Vachhani, Pankit; Arora, Garima; Bhatia, Ravi; Lenneman, Carrie G
• Is Part Of: Vascular medicine. Volume 25:Number 3(2020)
• Page Start: 246
• Page End: 254
• Publication Date: 2020-06
• Subjects: arterial thrombosis -- cardiovascular disease -- peripheral artery disease (PAD) -- risk factors -- stroke -- tyrosine kinase inhibitors -- venous thromboembolism (VTE); Blood-vessels -- Diseases -- Periodicals; Peripheral vascular diseases -- Periodicals; Vascular Diseases -- Periodicals; Vaisseaux sanguins -- Maladies -- Périodiques; Maladies vasculaires périphériques -- Périodiques; 616.13
• DOI: 10.1177/1358863X20906868
• Languages: English
• ISSNs: 1358-863X

Abstract

Tyrosine kinase inhibitors (TKIs) of the BCR-ABL fusion protein have dramatically changed the mortality of chronic myeloid leukemia (CML) but they carry a risk of serious vascular morbidity. While TKIs do not cure CML, daily oral administration of a TKI can control CML and TKIs are chronic medications. Interestingly, vascular complications can occur at any time a patient is on a TKI. Therefore, it is imperative that all care team members and patients are aware of and watching for possible vascular complications. In the following review, a case of arterial thrombosis secondary to the TKI ponatinib is presented as well as a discussion of thrombotic and vascular adverse events reported with TKIs. TKIs are metabolized through the cytochrome P450 system and important drug interactions to consider are reviewed. Finally, we present a multidisciplinary approach to the management of patients with CML on TKIs.