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Seguro FS, Silva CMPDC, Moura CMB, et al. Recommendations for the management of cardiovascular risk in patients with chronic myeloid leukemia on tyrosine kinase inhibitors: risk assessment, stratification, treatment and monitoring. Hematol Transfus Cell Ther. 2020;43(2):191-200doi: 10.1016/j.htct.2020.04.009.
Seguro, F. S., Silva, C. M. P. D. C., Moura, C. M. B., Conchon, M., Fogliatto, L., Funke, V. A. M., Abdo, A., Macedo, A. V. S., Santos, M. H. H. D., & Saraiva, J. F. K. (2021). Recommendations for the management of cardiovascular risk in patients with chronic myeloid leukemia on tyrosine kinase inhibitors: risk assessment, stratification, treatment and monitoring. Hematology, transfusion and cell therapy, 43(2), 191-200. https://doi.org/10.1016/j.htct.2020.04.009
Seguro, Fernanda Salles, et al. "Recommendations for the management of cardiovascular risk in patients with chronic myeloid leukemia on tyrosine kinase inhibitors: risk assessment, stratification, treatment and monitoring." Hematology, transfusion and cell therapy vol. 43,2 (2021): 191-200. doi: https://doi.org/10.1016/j.htct.2020.04.009
Seguro FS, Silva CMPDC, Moura CMB, Conchon M, Fogliatto L, Funke VAM, Abdo A, Macedo AVS, Santos MHHD, Saraiva JFK. Recommendations for the management of cardiovascular risk in patients with chronic myeloid leukemia on tyrosine kinase inhibitors: risk assessment, stratification, treatment and monitoring. Hematol Transfus Cell Ther. 2021 Apr-Jun;43(2):191-200. doi: 10.1016/j.htct.2020.04.009. Epub 2020 Jul 01. PMID: 32631809; PMCID: PMC8211634.
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Hematol Transfus Cell Ther. 2021 Apr-Jun;43(2):191-200. doi: 10.1016/j.htct.2020.04.009. Epub 2020 Jul 01.

Recommendations for the management of cardiovascular risk in patients with chronic myeloid leukemia on tyrosine kinase inhibitors: risk assessment, stratification, treatment and monitoring.

Hematology, transfusion and cell therapy

Fernanda Salles Seguro, Carolina Maria Pinto Domingues Carvalho Silva, Carla Maria Boquimpani de Moura, Monika Conchon, Laura Fogliatto, Vaneuza Araujo Moreira Funke, André Abdo, Ariane Vieira Scarlatelli Macedo, Marilia Harumi Higushi Dos Santos, José Francisco Kerr Saraiva

Affiliations

  1. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Instituto do Câncer do Estado de São Paulo, (ICESPSP), São Paulo, SP, Brazil. Electronic address: [email protected].
  2. Instituto do Câncer do Estado de São Paulo, (ICESPSP), São Paulo, SP, Brazil; Universidade de São Paulo (USP), São Paulo, SP, Brazil.
  3. HEMORIO, Rio de Janeiro, RJ, Brazil.
  4. Hospital Santa Marcelina, São Paulo, SP, Brazil.
  5. Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
  6. Universidade Federal do Paraná (UFPR), Curtitiba, PR, Brazil.
  7. Instituto do Câncer do Estado de São Paulo, (ICESPSP), São Paulo, SP, Brazil.
  8. Centro Paulista de Oncologia, Grupo Oncoclínicas do Brasil, São Paulo, SP, Brazil.
  9. Pontifícia Universidade Católica de Campinas, Faculdade de Medicina, SP, Brazil.

PMID: 32631809 PMCID: PMC8211634 DOI: 10.1016/j.htct.2020.04.009

Abstract

This manuscript summarizes the results of the consensus meeting composed of hematologists and cardiologists to establish recommendations for the prevention and follow-up of cardiovascular (CV) risk in patients with chronic myeloid leukemia (CML) treated with BCR-ABL tyrosine kinase inhibitors (TKIs) from the point of view of clinical practice and from the perspective of hematology consultation. In the first medical appointment, the CV risk factors should be identified to perform the baseline risk stratification, based on the Brazilian Guideline of Dyslipidemia and Atherosclerosis Prevention Update (risk levels: very high, high, intermediate and low). Once stratified, the treatment of the CV risk factors should be administered. If the patient presents risk factors, such as hypertension, diabetes, renal disease, smoking and hypercholesterolemia, the evaluation and initial treatment may be done by the hematologist, being an option the request for evaluation by a specialist. If the patient has a history of previous CV disease, we recommend referral to a specialist. As the CV risk score is dynamic and the control of risk factors can reduce the patient risk, this expert consensus recommends that the re-evaluation of the CV risk after the baseline should be performed at 3 months, 6 months and 12 months. After this period, it should be done annually and, for specific patients, at the clinician's discretion. The evaluation of the baseline CV risk and the safe administration of a TKI allow the patient to benefit from the maximum treatment, avoiding unwanted effects.

Copyright © 2020 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.

Keywords: Cardiovascular diseases; Leukemia, myeloid; Protein kinase inhibitors; Risk factors; Risk management

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