PMID- 30892724 OWN - NLM STAT- MEDLINE DCOM- 20190909 LR - 20210109 IS - 1099-1069 (Electronic) IS - 0278-0232 (Print) IS - 0278-0232 (Linking) VI - 37 IP - 3 DP - 2019 Aug TI - Arterial occlusive events in chronic myeloid leukemia patients treated with ponatinib in the real-life practice are predicted by the Systematic Coronary Risk Evaluation (SCORE) chart. PG - 296-302 LID - 10.1002/hon.2606 [doi] AB - Arterial occlusive events (AOEs) represent emerging complications in chronic myeloid leukemia (CML) patients treated with ponatinib. We identified 85 consecutive CML adult patients who were treated with ponatinib in 17 Italian centers. Patients were stratified according to the Systematic Coronary Risk Evaluation (SCORE) assessment, based on sex, age, smoking habits, systolic blood pressure, and total cholesterol levels. The 60-month cumulative incidence rate of AOEs excluding hypertension was 25.7%. Hypertension was reported in 14.1% of patients. The median time of exposure to ponatinib was 28 months (range, 3-69 months). Patients with a high to very high SCORE risk showed a significantly higher incidence rate of AOEs (74.3% vs 15.2%, P < 0.001). Patients aged >/=60 years showed a significantly higher incidence rate of AOEs (51.5% vs 16.9%, P = 0.008). In multivariate analysis, no association was found between AOEs and positive history of CV disease, age, dose of ponatinib, previous exposure to nilotinib, and comorbidities. Only the SCORE risk was confirmed as a significant predictive factor (P = 0.01; HR = 10.9; 95% C.I. = 1.7-67.8). Patients aged >/=60 years who were treated with aspirin had a lower incidence rate of AOEs (33.3% vs 61.8%). Among the 14 reported AOEs, 78.6% of them showed grade 3 to 4 toxicity. This real-life study confirmed the increased incidence of AOEs in CML patients treated with ponatinib, with high to very high SCORE risk. We suggest that patients aged >/=60 years who were treated with ponatinib should undergo prophylaxis with 100 mg/day of aspirin. Our findings emphasize personalized prevention strategies based on CV risk factors. CI - (c) 2019 The Authors Hematological Oncology Published by John Wiley & Sons Ltd. FAU - Caocci, Giovanni AU - Caocci G AUID- ORCID: 0000-0002-6585-5187 AD - Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. FAU - Mulas, Olga AU - Mulas O AD - Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. FAU - Abruzzese, Elisabetta AU - Abruzzese E AD - Hematology Unit, Sant'Eugenio Hospital Tor Vergata University, Rome, Italy. FAU - Luciano, Luigiana AU - Luciano L AD - Hematology Unit "Federico II" University of Naples, Naples, Italy. FAU - Iurlo, Alessandra AU - Iurlo A AD - Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. FAU - Attolico, Immacolata AU - Attolico I AD - Department of Emergency and Organ Transplantation-Hematology Section, University of Bari, Bari, Italy. FAU - Castagnetti, Fausto AU - Castagnetti F AD - Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. FAU - Galimberti, Sara AU - Galimberti S AD - Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy. FAU - Sgherza, Nicola AU - Sgherza N AD - Hematology and Transplant Center, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy. FAU - Bonifacio, Massimiliano AU - Bonifacio M AUID- ORCID: 0000-0003-0716-1686 AD - Department of Medicine, Section of Hematology, University of Verona, Verona, Italy. FAU - Annunziata, Mario AU - Annunziata M AD - Hematology Unit, Cardarelli Hospital, Naples, Italy. FAU - Gozzini, Antonella AU - Gozzini A AD - Hematology Unit, AOU Careggi, University of Florence, Florence, Italy. FAU - Orlandi, Ester Maria AU - Orlandi EM AD - Division of Hematology, "Fondazione IRCCS Policlinico S. Matteo", Pavia, Italy. FAU - Stagno, Fabio AU - Stagno F AD - Hematology Unit, AOU Policlinico-V. Emanuele, Rodolico Hospital, Catania, Italy. FAU - Binotto, Gianni AU - Binotto G AD - Hematology Unit, University of Padova, Padua, Italy. FAU - Pregno, Patrizia AU - Pregno P AD - Hematology Unit, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza, Torino, Italy. FAU - Fozza, Claudio AU - Fozza C AUID- ORCID: 0000-0001-7253-5432 AD - Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. FAU - Trawinska, Malgorzata Monika AU - Trawinska MM AD - Hematology Unit, Sant'Eugenio Hospital Tor Vergata University, Rome, Italy. FAU - De Gregorio, Fiorenza AU - De Gregorio F AD - Hematology Unit "Federico II" University of Naples, Naples, Italy. FAU - Cattaneo, Daniele AU - Cattaneo D AD - Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. FAU - Albano, Francesco AU - Albano F AD - Department of Emergency and Organ Transplantation-Hematology Section, University of Bari, Bari, Italy. FAU - Gugliotta, Gabriele AU - Gugliotta G AD - Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. FAU - Barate, Claudia AU - Barate C AD - Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy. FAU - Scaffidi, Luigi AU - Scaffidi L AD - Department of Medicine, Section of Hematology, University of Verona, Verona, Italy. FAU - Elena, Chiara AU - Elena C AD - Division of Hematology, "Fondazione IRCCS Policlinico S. Matteo", Pavia, Italy. FAU - Pirillo, Francesca AU - Pirillo F AD - Hematology Unit, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza, Torino, Italy. FAU - Scalzulli, Emilia AU - Scalzulli E AD - Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy. FAU - La Nasa, Giorgio AU - La Nasa G AD - Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. FAU - Foa, Robin AU - Foa R AD - Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy. FAU - Breccia, Massimo AU - Breccia M AD - Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20190417 PL - England TA - Hematol Oncol JT - Hematological oncology JID - 8307268 RN - 0 (Imidazoles) RN - 0 (Pyridazines) RN - 4340891KFS (ponatinib) RN - R16CO5Y76E (Aspirin) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Aspirin/therapeutic use MH - Cardiology/methods MH - Coronary Occlusion/*chemically induced/complications MH - Decision Support Systems, Clinical MH - Female MH - Humans MH - Hypertension/chemically induced MH - Imidazoles/*adverse effects/therapeutic use MH - Incidence MH - Italy/epidemiology MH - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications/*drug therapy MH - Male MH - Medical Oncology/methods MH - Middle Aged MH - Pyridazines/*adverse effects/therapeutic use MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome MH - Young Adult PMC - PMC6766852 OTO - NOTNLM OT - arterial occlusive event OT - chronic myeloid leukemia OT - ponatinib OT - prophylaxis EDAT- 2019/03/21 06:00 MHDA- 2019/09/10 06:00 PMCR- 2019/09/30 CRDT- 2019/03/21 06:00 PHST- 2019/01/21 00:00 [received] PHST- 2019/03/14 00:00 [accepted] PHST- 2019/03/21 06:00 [pubmed] PHST- 2019/09/10 06:00 [medline] PHST- 2019/03/21 06:00 [entrez] PHST- 2019/09/30 00:00 [pmc-release] AID - HON2606 [pii] AID - 10.1002/hon.2606 [doi] PST - ppublish SO - Hematol Oncol. 2019 Aug;37(3):296-302. doi: 10.1002/hon.2606. Epub 2019 Apr 17.