Adverse events among chronic myelogenous leukemia patients treated with tyrosine kinase inhibitors: a real-world analysis of health plan enrollees.

Abstract

With tyrosine kinase inhibitor (TKI) therapy, chronic myelogenous leukemia (CML) is now a chronic disease. CML patients treated with TKIs (n = 1200) were identified from the OptumLabs® Data Warehouse (de-identified claims and electronic health records) between 2000 and 2016 and compared with a non-cancer cohort (n = 7635). The 5-year cumulative incidence of all organ system outcomes was significantly greater for the TKI versus non-cancer group. In the first year, compared with imatinib, later generation TKIs were associated with primary infections (hazard ratios [HR] 1.43, 95% CI 1.02-2.00), circulatory events (HR 1.15, 95% CI 1.01-1.31), and skin issues (HR 1.43, 95% CI 1.13-1.80); musculoskeletal and nervous system/sensory issues were less common (HRs 0.83-0.84, p < 0.05). Increased risk of infections, cardiopulmonary and skin issues associated with later generation TKIs persisted in subsequent years. In this real-world population, TKI therapy was associated with a high burden of adverse events. Later generation TKIs may have greater toxicity than imatinib.

• Authors: Eric J Chow, David R Doody, Jennifer J Wilkes, Laura K Becker, Shasank Chennupati, Pamela E Morin, Lena E Winestone, Henry J Henk, Gary H Lyman
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 62 Issue 5 Pg. 1203-1210 (05 2021) ISSN: 1029-2403 [Electronic] United States
• PMID: 33283555 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Protein Kinase Inhibitors
• Imatinib Mesylate

Topics

• Chronic Disease
• Cohort Studies
• Humans
• Imatinib Mesylate (adverse effects)
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, epidemiology)
• Protein Kinase Inhibitors (adverse effects)