Vnitr Lek 2025, 71(3):E7-E10 | DOI: 10.36290/vnl.2025.036

Tyrosine kinase inhibitors and cardiovascular and metabolic risks in patients with chronic myeloid leukemia

Pavel Kraml

Interní klinika 3. LF UK a FN Královské Vinohrady, Praha

The oncology therapy represents an independent cardiovascular risk factor. For chronic myeloid leukemia (CML), the BCR:ABL1 tyrosine kinase inhibitors (TKI) have become the frontline therapy. While the first generation inhibitor (imatinib) revealed a relatively safe cardiovascular profile, the introduction of the second and third generation TKIs was associated with an in -crease of cardiovascular events as well as worsening of their risk factors, esp. hypertension, hyperglycemia, dyslipidemia and renal failure. Other observed side effects include pulmonary hypertension, pericardial and pleural effusions, arrhythmias and to lesser extent venous thrombosis. Before initiating the hemato-oncology therapy, it is necessary to assess the individual cardiovascular risk using SCORE2, SCORE2-OP or SCORE2-DM charts/calculators as well as to estimate the drug cardiovas -cular toxicity according to the recent ECS cardio-oncology guidelines (ICOS) and to perform regular follow-up of selected parameters during the TKI therapy (BP, blood lipids, HbA1c, urine analysis, eGFR, ABR, ecg) with respect to the specific TKI.

Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, cardiovascular risk.

Accepted: April 28, 2025; Published: May 16, 2025  Show citation