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Adverse outcomes in...
Adverse outcomes in chronic myeloid leukemia patients treated with tyrosine kinase inhibitors : Follow-up of patients diagnosed 2002-2017 in a complete coverage and nationwide agnostic register study
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- Dahlén, Torsten (författare)
- Karolinska Institutet
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- Edgren, Gustaf (författare)
- Karolinska Institutet
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- Ljungman, Per (författare)
- Karolinska Institutet
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- Flygt, Hjalmar (författare)
- Uppsala universitet,Hematologi,Univ Hosp, Div Hematol, Uppsala, Sweden.
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- Richter, Johan (författare)
- Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Lund, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
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- Olsson-Strömberg, Ulla (författare)
- Uppsala universitet,Hematologi,Univ Hosp, Div Hematol, Uppsala, Sweden.
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- Wadenvik, Hans (författare)
- Sahlgrens Univ Hosp, Sect Hematol, Gothenburg, Sweden.,Section of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden
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- Dreimane, Arta (författare)
- Region Östergötland, Hematologiska kliniken US,Department of Hematology, Linköping University Hospital, Linköping, Sweden,Linköping Univ Hosp, Dept Hematol, Linköping, Sweden.
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- Myhr-Eriksson, Kristina (författare)
- Sunderby Hosp, Dept Hematol, Luleå, Sweden.,Department of Hematology, Sunderby Hospital, Luleå, Sweden
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- Zhao, Jingcheng (författare)
- Karolinska Institutet
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- Själander, Anders (författare)
- Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, Sundsvall, Sweden.
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- Höglund, Martin (författare)
- Uppsala universitet,Hematologi,Univ Hosp, Div Hematol, Uppsala, Sweden.
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- Stenke, Leif (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2022-01-20
- 2022
- Engelska.
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Ingår i: American Journal of Hematology. - : Wiley. - 0361-8609 .- 1096-8652. ; 97:4, s. 421-430
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Abstract
Ämnesord
Stäng
- Tyrosine kinase inhibitors (TKIs) have profoundly improved the clinical outcome for patients with chronic myeloid leukemia (CML), but their overall survival is still subnormal and the treatment is associated with adverse events. In a large cohort-study, we assessed the morbidity in 1328 Swedish CML chronic phase patients diagnosed 2002-2017 and treated with TKIs, as compared to that in carefully matched control individuals. Several Swedish patient registers with near-complete nationwide coverage were utilized for data acquisition. Median follow-up was 6 (IQR, 3-10) years with a total follow-up of 8510 person-years for the full cohort. Among 670 analyzed disease categories, the patient cohort showed a significantly increased risk in 142 while, strikingly, no category was more common in controls. Increased incidence rate ratios/IRR (95% CI) for more severe events among patients included acute myocardial infarction (AMI) 2.0 (1.5-2.6), heart failure 2.6 (2.2-3.2), pneumonia 2.8 (2.3-3.5), and unspecified sepsis 3.5 (2.6-4.7). When comparing patients on 2nd generation TKIs vs. imatinib in a within-cohort analysis, nilotinib generated elevated IRRs for AMI (2.9; 1.5-5.6) and chronic ischemic heart disease (2.2; 1.2-3.9), dasatinib for pleural effusion (11.6; 7.6-17.7) and infectious complications, for example, acute upper respiratory infections (3.0; 1.4-6.0). Our extensive real-world data reveal significant risk increases of severe morbidity in TKI-treated CML patients, as compared to matched controls, particularly for 2nd generation TKIs. Whether this increased morbidity may also translate into increased mortality, thus preventing CML patients to achieve a normalized overall survival, needs to be further explored.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
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Till lärosätets databas
- Av författaren/redakt...
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Dahlén, Torsten
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Edgren, Gustaf
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Ljungman, Per
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Flygt, Hjalmar
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Richter, Johan
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Olsson-Strömberg ...
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visa fler...
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Wadenvik, Hans
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Dreimane, Arta
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Myhr-Eriksson, K ...
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Zhao, Jingcheng
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Själander, Ander ...
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Höglund, Martin
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Stenke, Leif
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Hematologi
- Artiklar i publikationen
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American Journal ...
- Av lärosätet
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Linköpings universitet
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Umeå universitet
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Uppsala universitet
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Karolinska Institutet