Tyrosine kinase inhibitors seem safe in CML with CKD

(HealthDay)—Tyrosine kinase inhibitors (TKIs) appear to be safe in patients with chronic-phase (CP) chronic myeloid leukemia (CML) and chronic kidney disease (CKD), according to a study published online July 28 in Cancer.

Musa Yilmaz, M.D., from the Baylor College of Medicine in Houston, and colleagues examined the incidence of acute kidney injury (AKI) and CKD in 468 newly diagnosed imatinib-, dasatinib-, and nilotinib-treated CP CML patients. From the start of therapy to the last follow-up, the authors assessed molecular and cytogenetic response data, creatinine, and glomerular filtration rate (GFR).

The researchers found that 4 percent of patients had TKI-linked AKI. Compared with dasatinib and nilotinib, imatinib correlated with increased incidence of AKI (P = 0.014). Fourteen percent of patients developed CKD while receiving a TKI, of whom 84 percent were receiving imatinib (P < 0.001). The development of CKD correlated with imatinib, age, history of hypertension, and diabetes mellitus. Imatinib reduced GFR over time in patients with no CKD at baseline, while in patients with a history of CKD, imatinib did not cause a significant decline in GFR. After three months of treatment, imatinib, dasatinib, and nilotinib increased the mean GFR, with the most significant increase for nilotinib (P < 0.001).

"The administration of TKIs may be safe in the setting of CKD in CP CML patients, but close monitoring is still warranted," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.