尼洛替尼治疗慢性髓系白血病患者心血管事件发生率和颈动脉USG异常:一项20年单中心研究

IF 2.7 4区 医学 Q2 HEMATOLOGY
Youngeun Jang, Joon Ho Moon, Yunji Lee, Jung Min Lee, Dong Won Baek, Soon Hee Chang, Sang Kyun Sohn
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引用次数: 0

摘要

背景:在接受尼洛替尼治疗的患者中,心血管事件(CVEs)的发生率是一个关键问题,特别是对于那些长期使用的患者。本研究旨在评估慢性髓性白血病(CML)患者cve的发生率,并评估颈动脉超声(USG)对尼罗替尼治疗患者cve的预测效果。方法:我们回顾性分析了2000年1月至2024年5月在韩国庆北国立大学医院接受尼罗替尼治疗的218例CML慢性期患者。51例患者行颈动脉USG。cve被定义为急性冠状动脉综合征、缺血性卒中和外周动脉闭塞性疾病。结果:在218例患者中,41例(18.81%)发生cve,在尼罗替尼暴露期间发生率增加- 5年为15.0%,10年为32.6%,15年为39.9%。高血压、糖尿病、血脂异常等心血管危险因素影响cve的发生(P = 0.016)。尼罗替尼治疗后,危险因素≥2的患者组10年累计CVE发生率为64.0%。218例服用尼罗替尼的患者中有51例进行了颈动脉USG。心血管危险因素与USG异常的相关性无统计学意义(P = 1.00)。结论:尼罗替尼治疗CML患者与CVE发生率显著相关,CVE发生率随治疗时间和危险因素的增加而增加。我们的研究结果支持在第一年进行常规心血管监测,特别是颈动脉USG,并根据危险因素每1至2年定期随访。主动监测、风险调整随访和无治疗缓解可以帮助降低CVE风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence of Cardiovascular Events and Carotid Artery USG Abnormalities in Chronic Myeloid Leukemia Patients on Nilotinib Therapy: A 20-Year Single-Center Study.

Background: The incidence of cardiovascular events (CVEs) among patients receiving nilotinib is a critical concern, particularly for those on long-term use. This study aimed to evaluate the incidence of CVEs among chronic myeloid leukemia (CML) patients and assess the efficacy of carotid artery ultrasonography (USG) in predicting CVEs in nilotinib-treated patients.

Methods: We retrospectively reviewed 218 patients diagnosed with CML chronic phase who received nilotinib at the Kyungpook National University Hospital, South Korea, from January 2000 to May 2024. Carotid USG was performed on 51 patients. CVEs were defined as acute coronary syndrome, ischemic stroke, and peripheral arterial occlusive disease.

Results: Among 218 patients, 41 (18.81%) experienced CVEs, with incidence increasing throughout nilotinib exposure - 15.0% at 5 years, 32.6% at 10 years, and 39.9% at 15 years. Cardiovascular risk factors, including hypertension, diabetes mellitus, dyslipidemia, influenced the occurrence of CVEs (P = .016). The 10-year cumulative CVE incidence in the patient group with ≥2 risk factors was 64.0% after nilotinib treatment. Carotid artery USG was performed in 51 out of 218 patients taking nilotinib. The correlation between cardiovascular risk factors and USG abnormalities was not statistically significant (P = 1.00).

Conclusions: Nilotinib treatment in CML patients is associated with significant CVE incidence, which increases with treatment duration and the number of risk factors. Our findings support routine cardiovascular monitoring, particularly carotid USG, within the first year and regular follow-ups every 1 to 2 years based on risk factors. Proactive monitoring, risk-adjusted follow-up, and treatment-free remission considerations could help mitigate CVE risks.

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来源期刊
CiteScore
2.70
自引率
3.70%
发文量
1606
审稿时长
26 days
期刊介绍: Clinical Lymphoma, Myeloma & Leukemia is a peer-reviewed monthly journal that publishes original articles describing various aspects of clinical and translational research of lymphoma, myeloma and leukemia. Clinical Lymphoma, Myeloma & Leukemia is devoted to articles on detection, diagnosis, prevention, and treatment of lymphoma, myeloma, leukemia and related disorders including macroglobulinemia, amyloidosis, and plasma-cell dyscrasias. The main emphasis is on recent scientific developments in all areas related to lymphoma, myeloma and leukemia. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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