Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors

Musa Yilmaz, Amit Lahoti, Susan O'Brien, Graciela M. Nogueras-González, Jan Burger, Alessandra Ferrajoli, Gautam Borthakur, Farhad Ravandi, Sherry Pierce, Elias Jabbour, Hagop Kantarjian, Jorge E. Cortes

Research output: Contribution to journalArticle

Abstract

BACKGROUND Chronic use of tyrosine kinase inhibitors (TKIs) may lead to previously unrecognized adverse events. This study evaluated the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD) in chronic-phase (CP) chronic myeloid leukemia (CML) patients treated with imatinib, dasatinib, and nilotinib. METHODS Four hundred sixty-eight newly diagnosed CP CML patients treated with TKIs were analyzed. The molecular and cytogenetic response data, creatinine, and glomerular filtration rate (GFR) were followed from the start of therapy to the last follow-up (median, 52 months). GFR was estimated with the Modification of Diet in Renal Disease equation. RESULTS Nineteen patients (4%) had TKI-associated AKI. Imatinib was associated with a higher incidence of AKI in comparison with dasatinib and nilotinib (P = .014). Fifty-eight patients (14%) developed CKD while they were receiving a TKI; 49 of these patients (84%) did so while they were being treated with imatinib (P < .001). Besides imatinib, age, a history of hypertension, and diabetes mellitus were also associated with the development of CKD. In patients with no CKD at the baseline, imatinib was shown to reduce GFR over time. Interestingly, imatinib did not cause a significant decline in the GFRs of patients with a history of CKD. Imatinib, dasatinib, and nilotinib increased the mean GFR after 3 months of treatment, and nilotinib led with the most significant increase (P < .001). AKI or CKD had no significant impact on overall cytogenetic and molecular response rates or survival. CONCLUSIONS The administration of TKIs may be safe in the setting of CKD in CP CML patients, but close monitoring is still warranted. Cancer 2015;121:3894-3904.

Original languageEnglish (US)
Pages (from-to)3894-3904
Number of pages11
JournalCancer
Volume121
Issue number21
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Glomerular Filtration Rate
Chronic Renal Insufficiency
Protein-Tyrosine Kinases
Leukemia, Myeloid, Chronic Phase
Acute Kidney Injury
Cytogenetics
Diet Therapy
Physiologic Monitoring
Imatinib Mesylate
Creatinine
Diabetes Mellitus
Cohort Studies
Survival Rate
Hypertension
Kidney
4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide
Incidence
Therapeutics
Dasatinib

Keywords

  • chronic myeloid leukemia (CML)
  • dasatinib
  • glomerular filtration rate changes
  • imatinib
  • kidney injury
  • nilotinib
  • outcome
  • tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. / Yilmaz, Musa; Lahoti, Amit; O'Brien, Susan; Nogueras-González, Graciela M.; Burger, Jan; Ferrajoli, Alessandra; Borthakur, Gautam; Ravandi, Farhad; Pierce, Sherry; Jabbour, Elias; Kantarjian, Hagop; Cortes, Jorge E.

In: Cancer, Vol. 121, No. 21, 01.11.2015, p. 3894-3904.

Research output: Contribution to journalArticle

Yilmaz, M, Lahoti, A, O'Brien, S, Nogueras-González, GM, Burger, J, Ferrajoli, A, Borthakur, G, Ravandi, F, Pierce, S, Jabbour, E, Kantarjian, H & Cortes, JE 2015, 'Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors', Cancer, vol. 121, no. 21, pp. 3894-3904. https://doi.org/10.1002/cncr.29587
Yilmaz M, Lahoti A, O'Brien S, Nogueras-González GM, Burger J, Ferrajoli A et al. Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. Cancer. 2015 Nov 1;121(21):3894-3904. https://doi.org/10.1002/cncr.29587
Yilmaz, Musa ; Lahoti, Amit ; O'Brien, Susan ; Nogueras-González, Graciela M. ; Burger, Jan ; Ferrajoli, Alessandra ; Borthakur, Gautam ; Ravandi, Farhad ; Pierce, Sherry ; Jabbour, Elias ; Kantarjian, Hagop ; Cortes, Jorge E. / Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. In: Cancer. 2015 ; Vol. 121, No. 21. pp. 3894-3904.
@article{f22b0631479b44268cc8e9c29cd3aa05,
title = "Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors",
abstract = "BACKGROUND Chronic use of tyrosine kinase inhibitors (TKIs) may lead to previously unrecognized adverse events. This study evaluated the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD) in chronic-phase (CP) chronic myeloid leukemia (CML) patients treated with imatinib, dasatinib, and nilotinib. METHODS Four hundred sixty-eight newly diagnosed CP CML patients treated with TKIs were analyzed. The molecular and cytogenetic response data, creatinine, and glomerular filtration rate (GFR) were followed from the start of therapy to the last follow-up (median, 52 months). GFR was estimated with the Modification of Diet in Renal Disease equation. RESULTS Nineteen patients (4{\%}) had TKI-associated AKI. Imatinib was associated with a higher incidence of AKI in comparison with dasatinib and nilotinib (P = .014). Fifty-eight patients (14{\%}) developed CKD while they were receiving a TKI; 49 of these patients (84{\%}) did so while they were being treated with imatinib (P < .001). Besides imatinib, age, a history of hypertension, and diabetes mellitus were also associated with the development of CKD. In patients with no CKD at the baseline, imatinib was shown to reduce GFR over time. Interestingly, imatinib did not cause a significant decline in the GFRs of patients with a history of CKD. Imatinib, dasatinib, and nilotinib increased the mean GFR after 3 months of treatment, and nilotinib led with the most significant increase (P < .001). AKI or CKD had no significant impact on overall cytogenetic and molecular response rates or survival. CONCLUSIONS The administration of TKIs may be safe in the setting of CKD in CP CML patients, but close monitoring is still warranted. Cancer 2015;121:3894-3904.",
keywords = "chronic myeloid leukemia (CML), dasatinib, glomerular filtration rate changes, imatinib, kidney injury, nilotinib, outcome, tyrosine kinase inhibitor",
author = "Musa Yilmaz and Amit Lahoti and Susan O'Brien and Nogueras-Gonz{\'a}lez, {Graciela M.} and Jan Burger and Alessandra Ferrajoli and Gautam Borthakur and Farhad Ravandi and Sherry Pierce and Elias Jabbour and Hagop Kantarjian and Cortes, {Jorge E.}",
year = "2015",
month = "11",
day = "1",
doi = "10.1002/cncr.29587",
language = "English (US)",
volume = "121",
pages = "3894--3904",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "21",

}

TY - JOUR

T1 - Estimated glomerular filtration rate changes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors

AU - Yilmaz, Musa

AU - Lahoti, Amit

AU - O'Brien, Susan

AU - Nogueras-González, Graciela M.

AU - Burger, Jan

AU - Ferrajoli, Alessandra

AU - Borthakur, Gautam

AU - Ravandi, Farhad

AU - Pierce, Sherry

AU - Jabbour, Elias

AU - Kantarjian, Hagop

AU - Cortes, Jorge E.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - BACKGROUND Chronic use of tyrosine kinase inhibitors (TKIs) may lead to previously unrecognized adverse events. This study evaluated the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD) in chronic-phase (CP) chronic myeloid leukemia (CML) patients treated with imatinib, dasatinib, and nilotinib. METHODS Four hundred sixty-eight newly diagnosed CP CML patients treated with TKIs were analyzed. The molecular and cytogenetic response data, creatinine, and glomerular filtration rate (GFR) were followed from the start of therapy to the last follow-up (median, 52 months). GFR was estimated with the Modification of Diet in Renal Disease equation. RESULTS Nineteen patients (4%) had TKI-associated AKI. Imatinib was associated with a higher incidence of AKI in comparison with dasatinib and nilotinib (P = .014). Fifty-eight patients (14%) developed CKD while they were receiving a TKI; 49 of these patients (84%) did so while they were being treated with imatinib (P < .001). Besides imatinib, age, a history of hypertension, and diabetes mellitus were also associated with the development of CKD. In patients with no CKD at the baseline, imatinib was shown to reduce GFR over time. Interestingly, imatinib did not cause a significant decline in the GFRs of patients with a history of CKD. Imatinib, dasatinib, and nilotinib increased the mean GFR after 3 months of treatment, and nilotinib led with the most significant increase (P < .001). AKI or CKD had no significant impact on overall cytogenetic and molecular response rates or survival. CONCLUSIONS The administration of TKIs may be safe in the setting of CKD in CP CML patients, but close monitoring is still warranted. Cancer 2015;121:3894-3904.

AB - BACKGROUND Chronic use of tyrosine kinase inhibitors (TKIs) may lead to previously unrecognized adverse events. This study evaluated the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD) in chronic-phase (CP) chronic myeloid leukemia (CML) patients treated with imatinib, dasatinib, and nilotinib. METHODS Four hundred sixty-eight newly diagnosed CP CML patients treated with TKIs were analyzed. The molecular and cytogenetic response data, creatinine, and glomerular filtration rate (GFR) were followed from the start of therapy to the last follow-up (median, 52 months). GFR was estimated with the Modification of Diet in Renal Disease equation. RESULTS Nineteen patients (4%) had TKI-associated AKI. Imatinib was associated with a higher incidence of AKI in comparison with dasatinib and nilotinib (P = .014). Fifty-eight patients (14%) developed CKD while they were receiving a TKI; 49 of these patients (84%) did so while they were being treated with imatinib (P < .001). Besides imatinib, age, a history of hypertension, and diabetes mellitus were also associated with the development of CKD. In patients with no CKD at the baseline, imatinib was shown to reduce GFR over time. Interestingly, imatinib did not cause a significant decline in the GFRs of patients with a history of CKD. Imatinib, dasatinib, and nilotinib increased the mean GFR after 3 months of treatment, and nilotinib led with the most significant increase (P < .001). AKI or CKD had no significant impact on overall cytogenetic and molecular response rates or survival. CONCLUSIONS The administration of TKIs may be safe in the setting of CKD in CP CML patients, but close monitoring is still warranted. Cancer 2015;121:3894-3904.

KW - chronic myeloid leukemia (CML)

KW - dasatinib

KW - glomerular filtration rate changes

KW - imatinib

KW - kidney injury

KW - nilotinib

KW - outcome

KW - tyrosine kinase inhibitor

UR - http://www.scopus.com/inward/record.url?scp=84945490814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945490814&partnerID=8YFLogxK

U2 - 10.1002/cncr.29587

DO - 10.1002/cncr.29587

M3 - Article

C2 - 26217876

AN - SCOPUS:84945490814

VL - 121

SP - 3894

EP - 3904

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 21

ER -