TY - JOUR
T1 - Comparative analysis of pulmonary hypertension in patients treated with imatinib, nilotinib and dasatinib
AU - Minami, Mariko
AU - Arita, Takeshi
AU - Iwasaki, Hiromi
AU - Muta, Tsuyoshi
AU - Aoki, Takatoshi
AU - Aoki, Kenichi
AU - Yamasaki, Satoshi
AU - Matsushima, Takamitsu
AU - Kato, Koji
AU - Takenaka, Katsuto
AU - Tanimoto, Kazuki
AU - Kamimura, Tomohiko
AU - Ogawa, Ryosuke
AU - Akashi, Koichi
AU - Miyamoto, Toshihiro
N1 - Funding Information:
The authors would like to thank the medical and nursing staff working on the Fukuoka Blood and Marrow Transplantation Group for providing patients information. This work was supported, in part, by a Grant-in-Aid for Scientific Research (16H05340 & 26115009 to T.M. & Y.K.).
Publisher Copyright:
© 2017 John Wiley & Sons Ltd
PY - 2017/5
Y1 - 2017/5
N2 - Pulmonary hypertension (PH) is a rare, but life-threatening, adverse event in patients treated with tyrosine kinase inhibitors (TKIs), such as dasatinib, but has not been fully evaluated in patients treated with imatinib or nilotinib. We used echocardiography to noninvasively assess the incidence of PH in 105 patients with chronic myeloid leukaemia (CML) treated with imatinib (n = 37), nilotinib (n = 30) or dasatinib (n = 38). The mean triscupid regurgitation peak gradient (TRPG), which reflects pulmonary arterial pressure, was 22·7 mmHg in the imatinib group, 23·1 mmHg in the nilotinib group and 23·4 mmHg for dasatinib group. These values were not significantly different, but higher than those (19·0 mmHg) in newly diagnosed CML patients. A TRPG > 31 mmHg, marking possible PH onset, was detected in 9 of 105 patients: one (2·7%) treated with imatinib, three (10·0%) with nilotinib and five (13·2%) with dasatinib. Only three patients complained of dyspnoea, whereas the other six were asymptomatic. In addition, there was a tendency toward correlation of TRPG value and age or TKI treatment duration. These results suggested that treatment with not only dasatinib, but also imatinib and nilotinib, can be associated with subclinical PH. Noninvasive echocardiography is useful for screening, especially in older patients with long-term TKI treatment.
AB - Pulmonary hypertension (PH) is a rare, but life-threatening, adverse event in patients treated with tyrosine kinase inhibitors (TKIs), such as dasatinib, but has not been fully evaluated in patients treated with imatinib or nilotinib. We used echocardiography to noninvasively assess the incidence of PH in 105 patients with chronic myeloid leukaemia (CML) treated with imatinib (n = 37), nilotinib (n = 30) or dasatinib (n = 38). The mean triscupid regurgitation peak gradient (TRPG), which reflects pulmonary arterial pressure, was 22·7 mmHg in the imatinib group, 23·1 mmHg in the nilotinib group and 23·4 mmHg for dasatinib group. These values were not significantly different, but higher than those (19·0 mmHg) in newly diagnosed CML patients. A TRPG > 31 mmHg, marking possible PH onset, was detected in 9 of 105 patients: one (2·7%) treated with imatinib, three (10·0%) with nilotinib and five (13·2%) with dasatinib. Only three patients complained of dyspnoea, whereas the other six were asymptomatic. In addition, there was a tendency toward correlation of TRPG value and age or TKI treatment duration. These results suggested that treatment with not only dasatinib, but also imatinib and nilotinib, can be associated with subclinical PH. Noninvasive echocardiography is useful for screening, especially in older patients with long-term TKI treatment.
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U2 - 10.1111/bjh.14608
DO - 10.1111/bjh.14608
M3 - Article
C2 - 28340283
AN - SCOPUS:85016417259
SN - 0007-1048
VL - 177
SP - 578
EP - 587
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 4
ER -