Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Be Sure to Consider This When Selecting TKIs

Clin Lymphoma Myeloma Leuk; ePub 2017 Jun 16; Coutinho, et al

It is important to consider cardiovascular (CV) risk when selecting patients in which to use tyrosine kinase inhibitors (TKIs), according to a study involving more than 1,600 individuals.

Participants were adults with chronic myelogenous leukemia (CML). Investigators looked at CV conditions and risk factors at baseline and 5 years later. Among the results:

  • At 5 years, CV conditions were present in one-third of patients.
  • CV risk factors were present in 78%.
  • CML patients were 1.3 to 3.5 times more likely to have CV conditions compared with the general population.
  • They were 20% to 40% more likely to develop hypertension, diabetes, and obesity.
  • CV risk factor prevalence was not different between CML patients and the general population who lived in the US Stroke Belt.

The authors noted that their findings underscore the importance of following guidelines, suggesting that CV risk be considered when selecting TKIs.


Coutinho A, Makenbaeva D, Farrelly E, Landsan-Blumberg P, Lenihan D. Elevated cardiovascular disease risk in patients with chronic myelogenous leukemia seen in community-based oncology practices in the United States. [Published online ahead of print June 16, 2017]. Clin Lymphoma Myeloma Leuk. doi:10.1016/j.clml.2017.06.011.

This Week's Must Reads

Gene sequencing bone marrow in myelodysplastic syndrome, Duncavage EJ et al. N Engl J Med 2018;379:1028-41.

Levofloxacin prophylaxis in ALL, AML , Alexander S, et al. JAMA. 2018;320(10):995-1004

Genetic markers signal poor prognosis in MCL, Obr A et al. Clin Lymphoma Myeloma Leuk. 2018 Aug 23. doi: 10.1016/j.clml.2018.07.282

Disparities in ALL treatment toxicity, Taylor OA et al. Clin Cancer Res. 2018 Sep 11. doi: 10.1158/1078-0432.CCR-18-0939

Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0

Must Reads in CML

Treatment-free remission in CML, Mahon FX et al. Ann Intern Med. 2018 Feb 20. doi: 10.7326/M17-1094.

Bosulif Approved to Treat Newly-Diagnosed Ph+ CML, Avillion news release; 2017 Dec 19

Sprycel Approved for Children with Ph+ CML, FDA news release; 2017 Nov 9

Be Sure to Consider This When Selecting TKIs, Clin Lymphoma Myeloma Leuk; ePub 2017 Jun 16; Coutinho, et al

FDA Approves Iclusig for Certain Types of CML, ALL, Ariad news release; 2016 Nov 29