PMID- 33612681
OWN - NLM
STAT- MEDLINE
DCOM- 20210716
LR  - 20210825
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Print)
IS  - 0918-2918 (Linking)
VI  - 60
IP  - 14
DP  - 2021 Jul 15
TI  - Efficacy and Cardiovascular Adverse Events of Long-term Treatment with Tyrosine 
      Kinase Inhibitors for Chronic Myeloid Leukemia: A Report from the Nagasaki CML 
      Study Group.
PG  - 2207-2216
LID - 10.2169/internalmedicine.6620-20 [doi]
AB  - Objective The standard treatment for chronic myeloid leukemia (CML) is the 
      continuous use of tyrosine kinase inhibitors (TKIs), which results in a favorable 
      prognosis for the majority of patients. Recent studies have identified 
      cardiovascular diseases (CVDs) as late adverse events (AEs) related to TKIs. In 
      this study, we evaluated the long-term efficacy and AEs of TKIs, focusing on 
      CVDs. Methods We performed a retrospective survey of CML patients (diagnosed from 
      2001 to 2016) treated with TKIs in Nagasaki Prefecture. Clinical data were 
      obtained from their medical records. We analyzed the survival, estimated 
      cumulative incidence of CVDs, and risk factors for CVD among CML patients treated 
      with TKIs. Results The overall survival rate of 264 CML patients treated with 
      TKIs (median age 58 years old) was 89.6% [95% confidence interval (CI), 
      84.9-92.9%], and 80.5% (95% CI, 73.4-85.9%) at 5 and 10 years after the CML 
      diagnosis, respectively. CVD events occurred in 26 patients (9.8%, median age 
      67.5 years old) with a median 65.5 months of TKI treatment. The cumulative 
      incidences at 2 and 5 years was 2.4% (95% CI, 1.0-4.8%) and 5.2% (95% CI, 
      2.8-8.6%), respectively. Hypertension and a high SCORE chart risk at the 
      diagnosis of CML were associated with CVD events during TKI treatment. Conclusion 
      TKI treatment contributed to the long-term survival of CML patients in Nagasaki 
      Prefecture in a "real-world" setting, but the incidence of CVDs seemed to be 
      increased in these patients. A proper approach to managing risk factors for CVD 
      is warranted to reduce CVD events during TKI treatment.
FAU - Chiwata, Masahiko
AU  - Chiwata M
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
FAU - Itonaga, Hidehiro
AU  - Itonaga H
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Sato, Shinya
AU  - Sato S
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Hashimoto, Miki
AU  - Hashimoto M
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
FAU - Fujioka, Machiko
AU  - Fujioka M
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Kasai, Sachie
AU  - Kasai S
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
FAU - Sakamoto, Hikaru
AU  - Sakamoto H
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Toriyama, Eo
AU  - Toriyama E
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Nakashima, Jun
AU  - Nakashima J
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
AD  - Department of Hematology, Japan Community Health care Organization Isahaya 
      General Hospital, Japan.
FAU - Kamijo, Rena
AU  - Kamijo R
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
AD  - Department of Hematology, Sasebo City General Hospital, Japan.
FAU - Kitanosono, Hideaki
AU  - Kitanosono H
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
FAU - Kobayashi, Yuji
AU  - Kobayashi Y
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, National Hospital Organization Nagasaki Medical Center, 
      Japan.
FAU - Horai, Makiko
AU  - Horai M
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Taguchi, Masataka
AU  - Taguchi M
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Matsuo, Masatoshi
AU  - Matsuo M
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
AD  - Department of Hematology, Nagasaki Harbor Medical Center, Japan.
FAU - Makiyama, Junya
AU  - Makiyama J
AD  - Department of Hematology, Sasebo City General Hospital, Japan.
AD  - Department of Hematology, National Hospital Organization Nagasaki Medical Center, 
      Japan.
FAU - Takasaki, Yumi
AU  - Takasaki Y
AD  - Department of Hematology, Saint Francis Hospital, Japan.
FAU - Matsuo, Emi
AU  - Matsuo E
AD  - Department of Hematology, National Hospital Organization Nagasaki Medical Center, 
      Japan.
AD  - Department of Hematology, Saint Francis Hospital, Japan.
FAU - Horio, Kensuke
AU  - Horio K
AD  - Department of Hematology, Nagasaki Prefecture Shimabara Hospital, Japan.
FAU - Ando, Koji
AU  - Ando K
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic 
      Bomb Disease Institute, Nagasaki University, Japan.
FAU - Sawayama, Yasushi
AU  - Sawayama Y
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Taguchi, Jun
AU  - Taguchi J
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
AD  - Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Japan.
FAU - Kawaguchi, Yasuhisa
AU  - Kawaguchi Y
AD  - Department of Internal Medicine, National Hospital Organization Nagasaki 
      Hospital, Japan.
FAU - Tsushima, Hideki
AU  - Tsushima H
AD  - Department of Hematology, Nagasaki Harbor Medical Center, Japan.
FAU - Imanishi, Daisuke
AU  - Imanishi D
AD  - Department of Internal Medicine, Nagasaki Prefecture Gotochuoh Hospital, Japan.
FAU - Imaizumi, Yoshitaka
AU  - Imaizumi Y
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
FAU - Yoshida, Shinichiro
AU  - Yoshida S
AD  - Department of Hematology, National Hospital Organization Nagasaki Medical Center, 
      Japan.
FAU - Jo, Tatsuro
AU  - Jo T
AD  - Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Japan.
FAU - Nonaka, Hiroaki
AU  - Nonaka H
AD  - Department of Laboratory Medicine, Nagasaki Rosai Hospital, Japan.
FAU - Moriuchi, Yukiyoshi
AU  - Moriuchi Y
AD  - Department of Hematology, Sasebo City General Hospital, Japan.
FAU - Nagai, Kazuhiro
AU  - Nagai K
AD  - Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Japan.
FAU - Yokota, Ken-Ichi
AU  - Yokota KI
AD  - Biostatistics Section, Division of Scientific Data Registry, Atomic Bomb Disease 
      Institute, Nagasaki University, Japan.
FAU - Hata, Tomoko
AU  - Hata T
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic 
      Bomb Disease Institute, Nagasaki University, Japan.
FAU - Miyazaki, Yasushi
AU  - Miyazaki Y
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, 
      Nagasaki University Graduate School of Biomedical Sciences, Japan.
AD  - Department of Hematology, Nagasaki University Hospital, Japan.
AD  - Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic 
      Bomb Disease Institute, Nagasaki University, Japan.
LA  - eng
PT  - Journal Article
DEP - 20210222
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 (Protein Kinase Inhibitors)
SB  - IM
MH  - Aged
MH  - *Cardiovascular Diseases/chemically induced/epidemiology
MH  - Humans
MH  - *Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
MH  - Middle Aged
MH  - Protein Kinase Inhibitors/adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC8355380
OTO - NOTNLM
OT  - adverse event
OT  - cardiovascular disease
OT  - chronic myeloid leukemia
OT  - tyrosine kinase inhibitor
COIS- Author's disclosure of potential Conflicts of Interest (COI). Yasushi Miyazaki: 
      Honoraria, Novartis, Celgene, Dainippon-Sumitomo, Nipponshinnyaku, Chugai, 
      Otsuka, Astellas and Kyowa-Kirin; Research funding, Dainippon-Sumitomo.
EDAT- 2021/02/23 06:00
MHDA- 2021/07/17 06:00
PMCR- 2021/07/15
CRDT- 2021/02/22 05:50
PHST- 2021/02/23 06:00 [pubmed]
PHST- 2021/07/17 06:00 [medline]
PHST- 2021/02/22 05:50 [entrez]
PHST- 2021/07/15 00:00 [pmc-release]
AID - 10.2169/internalmedicine.6620-20 [doi]
PST - ppublish
SO  - Intern Med. 2021 Jul 15;60(14):2207-2216. doi: 10.2169/internalmedicine.6620-20. 
      Epub 2021 Feb 22.