PMID- 37686630
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230912
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 15
IP  - 17
DP  - 2023 Aug 31
TI  - Hematological Adverse Events with Tyrosine Kinase Inhibitors for Chronic Myeloid 
      Leukemia: A Systematic Review with Meta-Analysis.
LID - 10.3390/cancers15174354 [doi]
LID - 4354
AB  - Chronic myeloid leukemia (CML) is treated with tyrosine kinase inhibitors (TKI) 
      that target the pathological BCR-ABL1 fusion oncogene. The objective of this 
      statistical meta-analysis was to assess the prevalence of other hematological 
      adverse events (AEs) that occur during or after predominantly first-line 
      treatment with TKIs. Data from seventy peer-reviewed, published studies were 
      included in the analysis. Hematological AEs were assessed as a function of TKI 
      drug type (dasatinib, imatinib, bosutinib, nilotinib) and CML phase (chronic, 
      accelerated, blast). AE prevalence aggregated across all severities and phases 
      was significantly different between each TKI (p < 0.05) for anemia-dasatinib 
      (54.5%), bosutinib (44.0%), imatinib (32.8%), nilotinib (11.2%); 
      neutropenia-dasatinib (51.2%), imatinib (29.8%), bosutinib (14.1%), nilotinib 
      (14.1%); thrombocytopenia-dasatinib (62.2%), imatinib (30.4%), bosutinib (35.3%), 
      nilotinib (22.3%). AE prevalence aggregated across all severities and TKIs was 
      significantly (p < 0.05) different between CML phases for anemia-chronic (28.4%), 
      accelerated (66.9%), blast (55.8%); neutropenia-chronic (26.7%), accelerated 
      (63.8%), blast (36.4%); thrombocytopenia-chronic (33.3%), accelerated (65.6%), 
      blast (37.9%). An odds ratio (OR) with 95% confidence interval was used to 
      compare hematological AE prevalence of each TKI compared to the most common 
      first-line TKI therapy, imatinib. For anemia, dasatinib OR = 1.65, [1.51, 1.83]; 
      bosutinib OR = 1.34, [1.16, 1.54]; nilotinib OR = 0.34, [0.30, 0.39]. For 
      neutropenia, dasatinib OR = 1.72, [1.53, 1.92]; bosutinib OR = 0.47, [0.38, 
      0.58]; nilotinib OR = 0.47, [0.42, 0.54]. For thrombocytopenia, dasatinib OR = 
      2.04, [1.82, 2.30]; bosutinib OR = 1.16, [0.97, 1.39]; nilotinib OR = 0.73, 
      [0.65, 0.82]. Nilotinib had the greatest fraction of severe (grade 3/4) 
      hematological AEs (30%). In conclusion, the overall prevalence of hematological 
      AEs by TKI type was: dasatinib > bosutinib > imatinib > nilotinib. Study 
      limitations include inability to normalize for dosage and treatment duration.
FAU - Kronick, Olivia
AU  - Kronick O
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
FAU - Chen, Xinyu
AU  - Chen X
AUID- ORCID: 0000-0002-6769-3046
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
FAU - Mehra, Nidhi
AU  - Mehra N
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
FAU - Varmeziar, Armon
AU  - Varmeziar A
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
FAU - Fisher, Rachel
AU  - Fisher R
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
FAU - Kartchner, David
AU  - Kartchner D
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
FAU - Kota, Vamsi
AU  - Kota V
AUID- ORCID: 0000-0002-5290-9289
AD  - Department of Medicine, Hematology and Oncology, Georgia Cancer Center at Augusta 
      University, Augusta, GA 30912, USA.
FAU - Mitchell, Cassie S
AU  - Mitchell CS
AD  - Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia 
      Institute of Technology and Emory University School of Medicine, Atlanta, GA 
      30332, USA.
AD  - The Machine Learning Center at Georgia Tech, Georgia Institute of Technology, 
      Atlanta, GA 30332, USA.
LA  - eng
GR  - R21 CA232249/CA/NCI NIH HHS/United States
GR  - R21CA232249/NH/NIH HHS/United States
PT  - Journal Article
PT  - Review
DEP - 20230831
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC10486908
OTO - NOTNLM
OT  - Philadelphia chromosome
OT  - chronic myeloid leukemia
OT  - personalized medicine
OT  - tyrosine kinase inhibitor
COIS- The authors declare no conflict of interest. The funders had no role in the 
      design of the study; in the collection, analyses, or interpretation of data; in 
      the writing of the manuscript, or in the decision to publish the results.
EDAT- 2023/09/09 11:45
MHDA- 2023/09/09 11:46
PMCR- 2023/08/31
CRDT- 2023/09/09 01:15
PHST- 2023/06/30 00:00 [received]
PHST- 2023/08/24 00:00 [revised]
PHST- 2023/08/28 00:00 [accepted]
PHST- 2023/09/09 11:46 [medline]
PHST- 2023/09/09 11:45 [pubmed]
PHST- 2023/09/09 01:15 [entrez]
PHST- 2023/08/31 00:00 [pmc-release]
AID - cancers15174354 [pii]
AID - cancers-15-04354 [pii]
AID - 10.3390/cancers15174354 [doi]
PST - epublish
SO  - Cancers (Basel). 2023 Aug 31;15(17):4354. doi: 10.3390/cancers15174354.