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Cardiovascular risk in chronic myeloid leukaemia: A multidisciplinary consensus on screening and management

Milojkovic, D; Lyon, AR; Mehta, P; Dimitriadou, E; Choudhuri, S; Manisty, C; Cheshire, N; ... Clark, RE; + view all (2023) Cardiovascular risk in chronic myeloid leukaemia: A multidisciplinary consensus on screening and management. European Journal of Haematology 10.1111/ejh.13983. (In press). Green open access

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Abstract

INTRODUCTION: Tyrosine kinase inhibitors (TKIs) have become the mainstay of treatment for chronic myeloid leukaemia (CML), but cardiovascular (CV) risk and exacerbation of underlying risk factors associated with TKIs have become widely debated. Real-world evidence reveals little application of CV risk factor screening or continued monitoring within UK CML management. This consensus paper presents practical recommendations to assist healthcare professionals in conducting CV screening/comorbidity management for patients receiving TKIs. METHODS: We conducted a multidisciplinary panel meeting and two iterative surveys involving 10 CML specialists: five haematologists, two cardio-oncologists, one vascular surgeon, one haemato-oncology pharmacist and one specialist nurse practitioner. RESULTS: The panel recommended that patients commencing second-/third-generation TKIs undergo formal CV risk assessment at baseline, with additional investigations and involvement of cardiologists/vascular surgeons for those with high CV risk. During treatment, patients should undergo CV monitoring, with the nature and frequency of testing dependent on TKI and baseline CV risk. For patients who develop CV adverse events, decision-making around TKI interruption, cessation or change should be multidisciplinary and balance CV and haematological risk. CONCLUSION: The panel anticipates these recommendations will support healthcare professionals in implementing CV risk screening and monitoring, broadly and consistently, and thereby help optimise TKI treatment for CML.

Type: Article
Title: Cardiovascular risk in chronic myeloid leukaemia: A multidisciplinary consensus on screening and management
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ejh.13983
Publisher version: https://doi.org/10.1111/ejh.13983
Language: English
Additional information: © 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: Cardiovascular, chronic myeloid leukaemia, consensus, tyrosine kinase inhibitor
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10169602
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