Background and importance Pharmacological toxicity management of tyrosine kinase inhibitor (TKI) use is important in the setting of chronic use in chronic myeloid leukaemia (CML) patients.
Aim and objectives The aim of this study was to describe TKI toxicity in patients diagnosed with CML.
Material and methods This was a retrospective study of patients with CML treated in our hospital with TKIs from June 2010 to July 2019. We collected data on TKIs prescribed, treatment line, toxicities (haematological (TH)/non-haematological (NHT)) according to CTCAE V.5 and time of occurrence, demographic data, Charlson index, Sokal index, concomitant medication, molecular response and dose modifications/discontinuations.
Results A total of 37 patients (19/37 women, median age 59 years (33–89)) were included. The median Charlson index was 2 (0–8). The Sokal index at diagnosis (23/37) was: low (14), medium (6) and high (3). Patients had a median of 4 (0–12) drug prescriptions.
At the time of data analysis, the pattern of TKI prescriptions was: imatinib (23/37), dasatinib (4/37) and nilotinib (3/37) as firstline treatment; and imatinib (4/37), dasatinib (12/37), nilotinib (4/37), bosutinib (2/37) and ponatinib (1/37) as second or subsequent lines of treatment. When the data were collected, 18 patients achieved a deep molecular response (12/37 imatinib and 3/37 nilotinib).
Median toxicity/patient was 3 (1–13), appearing in an average time of 18 months (28 days–8 years) and 10 months (8 days–7 years) for TH (23/122) and NHT (99/122), respectively. Dose was reduced because of toxicity in 7/37 patients and was discontinued in 14/37.
Conclusion and relevance The analysis has allowed the implementation of a specific proactive follow-up for each drug, which means early recognition and management of the toxicities associated with TKIs to optimise treatment efficacy and safety, as well as patient quality of life.
References and/or acknowledgements No conflict of interest.
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