Hepatic adverse events associated with tyrosine kinase inhibitors in patients with chronic myeloid leukemia
10.3760/cma.j.issn.0578-1426.2018.09.006
- VernacularTitle:慢性髓系白血病患者酪氨酸激酶抑制剂相关的肝脏不良反应
- Author:
Xuelin DOU
1
;
Shasha WANG
;
Jilian FANG
;
Lu YU
;
Xin REN
;
Xiaojun HUANG
;
Qian JIANG
Author Information
1. 100044,北京大学人民医院北京大学血液病研究所造血干细胞移植治疗血液病北京重点实验室
- Keywords:
Leukemia,myelogenous,chronic;
Tyrosine kinase inhibitor;
Liver adverse events
- From:
Chinese Journal of Internal Medicine
2018;57(9):649-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the incidence and severity of hepatic adverse events (AEs) and identify factors associated with hepatic AEs in patients with chronic myeloid leukemia (CML) in chronic phase (CP) treated with tyrosine kinase inhibitors (TKIs).Methods Liver biochemistry parameters [including ALT(alanine aminotransferase),AST(aspartate aminotransferase),ALP(alkaline phosphatase),and TBil(total bilirubin)] during the first 6 months on imatinib (Gleevec(R)),dasatinib (Sprycel(R)) or nilotinib (Tasigna(R)) in CML-CP patients were collected and analyzed retrospectively.Results A total of 436 patients were enrolled in this study,including 271 with imatinib,58 with dasatinib,and 107 with nilotinib.The incidences of any abnormality of liver injury were 21.8％(59/271),15.5％(9/58) and 32.7％(35/107) in the imatinib,dasatinib and nilotinib groups,respectively.Most of the hepatic AEs were CTCAE grade 1 or 2 and mild or moderate liver injury except 1.9％ of TBil CTCAE grade 3 in the nilotinib group.Multivariate analyses showed nilotinib [OR=2.9(1.3-6.6),P=0.012;OR=4.4(1.2-15.6),P=0.023] and male gender [OR=2.3(1.4-3.9),P=0.002;OR=3.0(1.2-7.6),P=0.018] were significantly associated with moderate liver impairment.Conclusions TKIs including imatinib,dasatinib and nilotinib were well tolerated with mild to moderate hepatic AEs in CML-CP patients.Nilotinib and male sex were associated with occurrence of liver biochemistry abnormalities and moderate hepatic injury.
