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Bull Cancer. 2016 Feb;103(2):180-9. doi: 10.1016/j.bulcan.2015.11.008. Epub 2016 Jan 11.

[Management of the cardiovascular disease risk during nilotinib treatment in chronic myeloid leukemia: 2015 recommendations from the France Intergroupe des Leucémies Myéloïdes Chroniques].

[Article in French]

Author information

1
Assistance publique-Hôpitaux de Paris, hôpital Saint-Louis, pôle hématologie-oncologie-radiothérapie, service d'hématologie adulte, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France. Electronic address: delphine.rea@aphp.fr.
2
Hôpital de Hautepierre, département d'hématologie et d'oncologie, CHU de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
3
Institut Paoli-Calmettes, département d'onco-hématologie, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France.
4
CHRU de Lille, service des maladies du sang, rue Michel-Polonovski, 59037 Lille cedex, France.
5
Centre hospitalier Annecy-Genevois, délégation à la recherche clinique et à l'innovation et service d'hématologie, 1, avenue de l'Hôpital, BP 90074, Metz-Tessy, 74374 Pringy, France.
6
Hôpital Pontchaillou, service d'hématologie clinique, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex, France.
7
Institut Bergonié, service d'oncologie médicale, 229, cours de l'Argonne, CS61283, 33076 Bordeaux cedex, France.
8
CHU d'Angers, service des maladies du sang, 4, rue Larrey, 49933 Angers cedex, France.
9
CHU de Nancy, service d'hématologie et de médecine interne, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
10
Hôpital de l'Archet, service d'hématologie, 151, route Saint-Antoine-de-Ginestière, 06200 Nice, France.
11
Centre hospitalier Lyon Sud, service d'hématologie clinique 1G, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Inserm U1052, CRCL, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
12
Hôpital Henri-Mondor, laboratoire d'hématologie, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
13
CHU Estaing, service de thérapie cellulaire et d'hématologie clinique adulte, 1, place Lucie-Aubrac, 63000 Clermont-Ferrand, France.
14
Institut universitaire du cancer Toulouse-Oncopole, service d'hématologie, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
15
CHU de Caen, institut d'hématologie, avenue de la Côte-de-Nacre, CS30001, 14033 Caen cedex, France.
16
Hôpital Saint-Antoine, service d'hématologie clinique et de thérapie cellulaire, 186, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
17
CHRU de Montpellier, département d'hématologie clinique, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
18
Hôpital André-Mignot, service d'hématologie oncologie, 177, rue de Versailles, 78157 Le Chesnay cedex, France.
19
Hôpital Haut-Lévèque, laboratoire d'hématologie, avenue Magellan, 33604 Pessac, France.
20
Hôpital européen Georges-Pompidou, service de médecine vasculaire, Inserm U970, 20, rue Leblanc, 75015 Paris, France.

Abstract

Tyrosine kinase inhibitors targeting the BCR-ABL oncoprotein represent an outstanding progress in chronic myeloid leukemia and long-term progression-free survival has become a reality for a majority of patients. However, tyrosine kinase inhibitors may at best chronicize rather than cure the disease thus current recommendation is to pursue treatment indefinitely. As a consequence, high quality treatment and care must integrate optimal disease control and treatment tolerability. Tyrosine kinase inhibitors have an overall favorable safety profile in clinical practice since most adverse events are mild to moderate in intensity. However, recent evidence has emerged that new generation tyrosine kinase inhibitors may sometimes damage vital organs and if not adequately managed, morbidity and mortality may increase. The 2nd generation tyrosine kinase inhibitor nilotinib is licensed for the treatment of chronic myeloid leukemia with resistance or intolerance to imatinib and newly diagnosed chronic phase-chronic myeloid leukemia. Nilotinib represents an important therapeutic option but it is associated with an increased risk of cardiovascular events. The purpose of this article by the France Intergroupe des Leucémies Myéloïdes Chroniques is to provide an overview of nilotinib efficacy and cardiovascular safety profile and to propose practical recommendations with the goal to minimize the risk and severity of cardiovascular events in nilotinib-treated patients.

KEYWORDS:

Cardiovascular risk; Chronic myeloid leukemia; Inhibiteur de tyrosine kinase; Leucémie myéloïde chronique; Nilotinib; Prevention; Prévention; Risque cardiovasculaire; Tyrosine kinase inhibitor

PMID:
26790711
DOI:
10.1016/j.bulcan.2015.11.008
[Indexed for MEDLINE]

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