Premium
Arterial occlusive events in chronic myeloid leukemia patients treated with ponatinib in the real‐life practice are predicted by the Systematic Coronary Risk Evaluation (SCORE) chart
Author(s) -
Caocci Giovanni,
Mulas Olga,
Abruzzese Elisabetta,
Luciano Luigiana,
Iurlo Alessandra,
Attolico Immacolata,
Castagnetti Fausto,
Galimberti Sara,
Sgherza Nicola,
Bonifacio Massimiliano,
Annunziata Mario,
Gozzini Antonella,
Orlandi Ester Maria,
Stagno Fabio,
Binotto Gianni,
Pregno Patrizia,
Fozza Claudio,
Trawinska Malgorzata Monika,
De Gregorio Fiorenza,
Cattaneo Daniele,
Albano Francesco,
Gugliotta Gabriele,
Baratè Claudia,
Scaffidi Luigi,
Elena Chiara,
Pirillo Francesca,
Scalzulli Emilia,
La Nasa Giorgio,
Foà Robin,
Breccia Massimo
Publication year - 2019
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2606
Subject(s) - medicine , ponatinib , incidence (geometry) , myeloid leukemia , nilotinib , cumulative incidence , aspirin , framingham risk score , cardiology , cohort , disease , imatinib , physics , optics
Arterial occlusive events (AOEs) represent emerging complications in chronic myeloid leukemia (CML) patients treated with ponatinib. We identified 85 consecutive CML adult patients who were treated with ponatinib in 17 Italian centers. Patients were stratified according to the Systematic Coronary Risk Evaluation (SCORE) assessment, based on sex, age, smoking habits, systolic blood pressure, and total cholesterol levels. The 60‐month cumulative incidence rate of AOEs excluding hypertension was 25.7%. Hypertension was reported in 14.1% of patients. The median time of exposure to ponatinib was 28 months (range, 3‐69 months). Patients with a high to very high SCORE risk showed a significantly higher incidence rate of AOEs (74.3% vs 15.2%, P < 0.001). Patients aged ≥60 years showed a significantly higher incidence rate of AOEs (51.5% vs 16.9%, P = 0.008). In multivariate analysis, no association was found between AOEs and positive history of CV disease, age, dose of ponatinib, previous exposure to nilotinib, and comorbidities. Only the SCORE risk was confirmed as a significant predictive factor ( P = 0.01; HR = 10.9; 95% C.I. = 1.7‐67.8). Patients aged ≥60 years who were treated with aspirin had a lower incidence rate of AOEs (33.3% vs 61.8%). Among the 14 reported AOEs, 78.6% of them showed grade 3 to 4 toxicity. This real‐life study confirmed the increased incidence of AOEs in CML patients treated with ponatinib, with high to very high SCORE risk. We suggest that patients aged ≥60 years who were treated with ponatinib should undergo prophylaxis with 100 mg/day of aspirin. Our findings emphasize personalized prevention strategies based on CV risk factors.