Cardiovascular toxicities of BCR-ABL tyrosine kinase inhibitors in chronic myeloid leukemia: preventive strategies and cardiovascular surveillance

Vasc Health Risk Manag. 2017 Aug 4:13:293-303. doi: 10.2147/VHRM.S108874. eCollection 2017.

Abstract

Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment and outcomes of chronic myeloid leukemia (CML). Despite their significant impact on the management of CML, there is growing evidence that TKIs may cause cardiovascular and/or metabolic complications. In this review, we present the current evidence regarding the cardiovascular safety profiles of BCR-ABL TKIs. Methodological challenges of studies that reported the cardiovascular safety of TKIs are discussed. We also propose management strategies for cardiovascular surveillance and risk factor modification during treatment with these agents.

Keywords: BCR-ABL; adverse event; cardiovascular disease; peripheral arterial disease; tyrosine kinase inhibitor.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects*
  • Cardiotoxicity
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / prevention & control
  • Decision Support Techniques
  • Fusion Proteins, bcr-abl / antagonists & inhibitors*
  • Fusion Proteins, bcr-abl / metabolism
  • Humans
  • Leukemia, Myeloid / drug therapy*
  • Leukemia, Myeloid / enzymology
  • Molecular Targeted Therapy
  • Patient Selection
  • Predictive Value of Tests
  • Protein Kinase Inhibitors / adverse effects*
  • Risk Assessment
  • Risk Factors

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Fusion Proteins, bcr-abl