Review Article

Cardiovascular Adverse Events and Mitigation Strategies for Chronic Myeloid Leukemia Patients Receiving Tyrosine Kinase Inhibitor Therapy

Lisa Nodzon, PhD, APRN, AOCNP®, Anecita Fadol, PhD, FNP-BC, FAANP, FAAN, and Sara Tinsley, PhD, APRN, AOCN®

From (1)H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida; (2)University of Texas MD Anderson Cancer Center, Houston, Texas

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Lisa Nodzon, PhD, APRN, AOCNP®, H. Lee Moffitt Cancer Center & Research Institute, Department of Malignant Hematology, 12902 USF Magnolia Drive, Tampa, FL 32601. E-mail: lisa.nodzon@moffitt.org

ABSTRACT

Cardiovascular (CV) risk mitigation is an important consideration in the management of chronic myeloid leukemia (CML) patients. Although BCR-ABL1 inhibition by tyrosine kinase inhibitors (TKI) has led to a significant improvement in prognosis, the majority of CML patients will require indefinite TKI therapy. Given the success of therapy, there has been a shift in focus to include CV care as part of routine patient management. To optimize outcomes, both patient-specific comorbidities and a detailed understanding of the cardiotoxicity safety profiles imparted by each TKI should be considered during agent selection. Clinicians face the challenge of early detection and management of these cardiotoxicities while balancing the risk-benefit ratios of maintaining life-saving cancer therapy. Advanced practitioners play a critical role in CML patient management that extends to the recognition and management of TKI-associated side effects. They should be cognizant of the potential for TKI-associated cardiotoxicities along with appropriate baseline risk assessments, active surveillance, and mitigation strategies as part of a collaborative team effort with cardio-oncologists.

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