Skin reactions to tyrosine kinase inhibitors in pediatric patients with chronic myeloid leukemia.

Cutaneous adverse events are commonly reported in adult patients with chronic myeloid leukemia (CML) receiving tyrosine kinase inhibitors (TKIs); however, little is known about the cutaneous reactions in children receiving TKIs for CML. As pediatric patients may require lifelong TKI therapy, it is essential to understand the wide range of potential cutaneous toxicities. We examined all case studies, cohort studies, and clinical trials in PubMed/MEDLINE and Embase that reported cutaneous reactions to first-, second-, and third-generation TKIs in children 18 years or younger with CML. This review article focuses on the TKI drug types and doses, patient demographic characteristics, features of skin reactions, and clinical outcomes.

Ponatinib-Related Vasospastic Angina.

Tyrosine kinase inhibitors (TKIs) are essential drugs for chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia. Cardiovascular or arteriothrombotic adverse events have been reported in patients treated with TKIs. We report 3 cases of Ponatinib-related vasospastic angina, in which prophylactic administration of nitrates or calcium channel blockers was effective.

Pharmacovigilance study of BCR-ABL1 tyrosine kinase inhibitors: a safety analysis of the FDA adverse event reporting system.

BACKGROUND: With the increased use of BCR-ABL1 tyrosine kinase inhibitors (TKIs) in cancer patients, adverse events (AEs) have garnered considerable interest. We conducted this pharmacovigilance study to evaluate the AEs of BCR-ABL1 TKIs in cancer patients using the Food and Drug Administration Adverse Event Reporting System (FAERS) database. METHODS: To query AE reports from the FAERS database, we used OpenVigil 2.1. Descriptive analysis was then employed to describe the characteristics of TKIs-associated AE reports. We also utilized the disproportionality analysis to detect safety signals by calculating the proportional reporting ratio (PRR) and reporting odds ratios (ROR). RESULTS: From the FAERS database, a total of 85,989 AE reports were retrieved, with 3,080 significant AE signals identified. Specifically, imatinib, nilotinib, dasatinib, bosutinib, and ponatinib had significant AE signals of 1,058, 813, 232, 186, and 791, respectively. These significant signals were further categorized into 26 system organ classes (SOCs). The AE signals of imatinib and ponatinib were primarily associated with general disorders and administration site conditions. On the other hand, nilotinib, dasatinib, and bosutinib were mainly linked to investigations, respiratory, thoracic and mediastinal disorders, and gastrointestinal disorders, respectively. Notably, new signals of 245, 278, 47, 55, and 253 were observed in imatinib, nilotinib, dasatinib, bosutinib, and ponatinib, respectively. CONCLUSIONS: The results of this study demonstrated that AE signals differ among the five BCR-ABL1 TKIs. Furthermore, each BCR-ABL1 TKI displayed several new signals. These findings provide valuable information for clinicians aiming to reduce the risk of AEs during BCR-ABL1 TKI treatment.

Necesidades y experiencia farmacoterapéutica de los pacientes con leucemia mieloide crónica tratados con inhibidores de la tirosina cinasa: revisión sistemática / Medication experience and patient’s related needs in chronic myeloid leukemia treated with tyrosine kinase inhibitors: Systematic review

Objetivo: diversas investigaciones cuantitativas generan evidencia sobre los pacientes con leucemia mieloide crónica y el tratamiento activo con inhibidores tirosina cinasa, pero son escasas las investigaciones cualitativas que orienten sus resultados a cómo acompañar a los pacientes a lo largo de su enfermedad. El objetivo es conocer las expectativas, las necesidades de información y las experiencias condicionantes al usar inhibidores tirosina cinasa en los pacientes con leucemia mieloide crónica en los estudios cualitativos publicados en la literatura científica.Métodosse revisaron sistemáticamente investigaciones cualitativas publicadas entre 2003 y 2021 en Pubmed/Medline, Web of Science y Embase de pacientes con leucemia mieloide crónica tratados con inhibidores tirosina cinasa. Las palabras clave fueron «Leukemia, Myeloid» y «Qualitative Research». Se excluyeron artículos sobre la fase aguda o blástica.Resultadosse localizaron 184 publicaciones. Eliminando los duplicados, se incluyeron 6 (3%) y excluyeron 176 (97%). Los estudios muestran la enfermedad como inflexión en la vida de los pacientes, quienes desarrollan sus propias estrategias para controlar los efectos adversos. Los factores que determinan la experiencia farmacoterapéutica con inhibidores tirosina cinasa deben abordarse mediante estrategias personalizadas: esto permitiría la detección temprana de problemas, reforzaría la educación en cada etapa y promovería la discusión abierta sobre las causas complejas que subyacen al fracaso del tratamiento. (AU)

Objective: Several studies quantitatively described patients with Chronic Myeloid Leukaemia on active treatment with tyrosine kinase inhibitors, however there are few qualitative studies that focus their results on how to accompany patients in the course of the disease over time. The objective of this review is to find out what are the expectations, information needs and experiences that determine adherence to treatment with tyrosine kinase inhibitors in patients with Chronic Myeloid Leukaemia in qualitative research articles published in the scientific literature.MethodsA systematic review of qualitative research articles published between 2003-2021 was carried out in PubMed/Medline, Web of Science and Embase databases. Main keywords used were: "Leukaemia, Myeloid" and "Qualitative Research". Articles on the acute phase or blast phase were excluded.Results184 publications were located. After elimination of duplicates, 6 (3%) were included and 176 (97%) publications were excluded. Studies show that the illness is a turning point in patients' lives, and they develop their own strategies for managing the adverse effects. The factors that determine medication experiences with tyrosine kinase inhibitors should be addressed by implementing personalized strategies: this would result in early detection of problems, reinforce education at each stage and promote open discussion about complex causes underlying the treatment failure. (AU)