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Prevalence of Late Effects of TKIs in Patients With CML

By: Jenna Carter, PhD
Posted: Tuesday, July 7, 2020

The long-term, off-target effects of tyrosine kinase inhibitors (TKIs) in children with chronic myeloid leukemia (CML) are poorly understood. Based on the retrospective cohort findings of a study by Stephanie M. Smith, MD, MPH, of Stanford University, and colleagues featured during the ASCO20 Virtual Scientific Program (Abstract e22527), institutional screening practices for cardiac and endocrine late effects in this patient population at two large pediatric cancer centers appear to be inconsistent.

“Evidence-based guidelines for long-term follow-up and structured monitoring for potential off-target effects are needed,” concluded the investigators, “A prospective screening study is in progress and may enhance our understanding of the prevalence of late effects of tyrosine kinase inhibitors.”

A total of 46 patients younger than age 21 with CML were included in the study; they had 6.3 years of exposure to TKIs. Imatinib was used in 80% of patients, and dasatinib was received by nearly 60%. Nearly half of the study patients had been exposed to at least one TKI. Demographics, clinical features, and incidence of screening echocardiogram, electrocardiogram, dual-energy x-ray absorptiometry, bone age, and thyroid function were measured.

Excluding initial diagnostic tests, the analyses revealed that 48% of patients with CML had an echocardiogram, and 48% had an electrocardiogram. Thyroid function, dual-energy x-ray absorptiometry, and bone age were measured in 50%, 9%, and 11% of patients, respectively. “A prospective screening study is in progress and may enhance our understanding of the prevalence of late effects of TKIs,” the investigators concluded.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.



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