An emerging challenge: tki-induced cardiovascular adverse events in cml patients

Abstract

The development and introduction of tyrosine kinase inhibitors (TKIs) marked a huge turning point in the treatment of chronic myeloid leukemia patients. Different adverse events have been encountered with the use of TKIs over the years. TKI-induced cardiovascular adverse events, in particular, are a cause of growing concern in CML therapy. Several studies reporting these cardiovascular adverse events have been conducted over the years. Current evidence largely shows that imatinib, a first-generation TKI is the least toxic to the cardiovascular system. Second and third-generation TKIs like dasatinib, nilotinib, and ponatinib, however, have a higher cardiovascular impact as several cases of cardiovascular adverse events have been reported with their use. In this review, we will present preliminary results from a retrospective analysis carried out at our institution. In addition, we will discuss the available evidence on the TKI-associated cardiovascular adverse events reported in the literature. Proposed clinical recommendations regarding risk modification, surveillance, and management of these adverse events will also be presented.