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Rev Port Cardiol. 2019 Jan;38(1):1-9. doi: 10.1016/j.repc.2017.10.013. Epub 2019 Jan 24.

New prospects for the management of cardiovascular effects of tyrosine kinase inhibitors in patients with chronic myeloid leukemia.

[Article in English, Portuguese]

Author information

1
Serviço de Cardiologia, Hospital Universitário de Santa Maria (CHLN), Centro Académico de Medicina de Lisboa e Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Lisboa, Portugal. Electronic address: anagalmeida@gmail.com.
2
Serviço de Hematologia, Instituto Português de Oncologia de Lisboa (IPOL FG), Lisboa, Portugal.
3
Serviço de Hematologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
4
Serviço de Hematologia, Assistente Hospitalar Senior de Hematologia, Lisboa, Portugal.
5
Barts Heart Centre, Barts Health NHS Trust, Institute of Cardiovascular Centre, University College Hospital, Londres, Inglaterra; Centro Cardiovascular da Universidade de Lisboa (CCUL), Lisboa, Portugal.
6
Serviço de Hematologia Clínica, Hospital dos Capuchos (CHLC), Lisboa, Portugal.
7
Serviço de Hematologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
8
Serviço de Hematologia, Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
9
Serviço de Cardiologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

Abstract

The use of tyrosine kinase inhibitors (TKIs) for the treatment of chronic myeloid leukemia has significantly altered the prognosis of this disease, enabling close to normal life expectancy. Despite their undeniable benefits, the use of TKIs is associated with an increased risk of side effects on the cardiovascular system, particularly of atherothrombotic events. It is therefore necessary to understand and prevent the adverse effects of these drugs, in order to enable antileukemic therapy to continue and to minimize patients' toxic exposure. This multidisciplinary consensus document, developed through a collaboration between hematologists and cardiologists, aims to review the cardiovascular toxicity associated with various TKIs and to establish recommendations for the follow-up of these patients. Measures are also proposed for the assessment and reduction of cardiovascular risk in these patients and referral criteria, and relevant drug interactions are discussed.

KEYWORDS:

Cardiotoxicidade; Cardiotoxicity; Cardio‐oncologia; Cardio‐oncology; Chemotherapy; Chronic myeloid leukemia; Inibidores da tirosinacinase; Leucemia mieloide crónica; Quimioterapia; Tyrosine kinase inhibitors

PMID:
30686651
DOI:
10.1016/j.repc.2017.10.013
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