1. Effect of Tyrosine Kinase Inhibitor Therapy on Estimated Glomerular Filtration Rate in Patients with Chronic Myeloid Leukemia.
- Author
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Sönmez Ö, Özgür Yurttaş N, İhtiyaroğlu İ, Çakır HM, Atlı Z, Elverdi T, Salihoğlu A, Seyahi N, Ar MC, Öngören Ş, Başlar Z, Soysal T, and Eşkazan AE
- Subjects
- Humans, Aged, Imatinib Mesylate, Tyrosine Kinase Inhibitors, Protein Kinase Inhibitors adverse effects, Glomerular Filtration Rate, Retrospective Studies, Dasatinib adverse effects, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Renal Insufficiency, Chronic etiology, Hypertension
- Abstract
Introduction: The advent of tyrosine kinase inhibitors (TKIs) was revolutionary in the management of chronic myeloid leukemia (CML). Although TKIs were generally considered to be safe, they can be associated with renal injury. We evaluated the effect of TKIs on renal functions in a cohort of patients with long-term follow-up., Material and Methods: We retrospectively examined patients with chronic phase CML treated with TKIs. We analyzed the estimated glomerular filtration rate (eGFR) of patients from the initiation of TKI to the last follow-up. eGFR values of CML patients were compared to those of patients with stage 1 or 2 chronic kidney disease (CKD)., Results: A total of 195 patients with CML and 138 patients with CKD were examined. eGFR decline was 1.556 ml/min/1.73m
2 /year for patients with CML (P = .221). Patients receiving second-generation TKIs (2GTKI) were estimated to have 0.583 ml/min/1.73m2 higher eGFR value than that of the imatinib group, but it was not significant (P = .871). eGFR of patients who had used bosutinib had a downward trend. Duration of TKI therapy, age, and hypertension were found to be significant factors in eGFR decline for CML patients. Lower baseline GFR was associated with an increased risk of CKD development., Conclusion: Imatinib could result in a decline in eGFR which was clinically similar to early-stage CKD patients. We did not observe significant kidney function deterioration in patients receiving 2GTKIs including dasatinib and nilotinib. We recommend close renal function monitoring in patients receiving imatinib, especially for elderly patients with lower baseline eGFR and hypertension., Competing Interests: Disclosure AEE has received advisory board and speaker bureau honoraria from Novartis, Bristol-Myers Squibb, and Pfizer, outside the present study. TS has received advisory board honoraria from Novartis, Bristol-Myers Squibb, and speaker honoraria from Novartis, outside the present study. All other authors have no conflict of interest to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2024
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