Journal Article

Low-density lipoprotein (LDL) levels and risk of arterial occlusive events in chronic myeloid leukemia patients treated with nilotinib

Galimberti, Sara, Pirillo Francesca, Efficace Fabio, Scaffidi Luigi, Simula Maria Pina, De Gregorio Fiorenza, Stella, Rossella, Gugliotta Gabriele, Mulas, Olga, Iurlo Alessandra, Cattaneo, Daniele, Capodanno Isabella, Trawinska, Malgorzata Monika, Martino, Bruno, Binotto Gianni, Luzi Debora, Stagno Fabio, Annunziata, Mario, Foà Robin, Bocchia Monica, Sicuranza, Anna, Fozza Claudio, Scalzulli Emilia, Bonifacio Massimiliano, Baratè Claudia, Breccia Massimo, Luigiana, Luciano, Abruzzese Elisabetta, Albano, Francesco, La Nasa Giorgio, Caocci Giovanni, Gozzini Antonella, Tiribelli Mario, Attolico Immacolata, Castagnetti Fausto, Pregno Patrizia

2021

Overview

Recommendations for dyslipidemia management aimed at reducing arterial occlusive events (AOEs) have been recently published. So far, no data have been reported on the management of dyslipidemia in chronic myeloid leukemia (CML) patients treated with nilotinib. We investigated 369 CML adult patients, stratified according to the new Systematic Coronary Risk Evaluation (SCORE) scoring system. Plasma levels of cholesterol, HDL, LDL, and triglycerides were measured prior to the start of nilotinib and after 3, 6, and 12 months. The 5-year cumulative incidence of AOEs was 15.9%. Patients with cholesterol levels > 200 mg/dL and LDL > 70 mg/dL 3 months after treatment showed a significantly higher incidence of AOEs (21.9 ± 4.6% vs 6.2 ± 2.5, P = 0.003). Patients belonging to the high and very high SCORE risk group showed a significant increase of AOEs (34.4 ± 6% vs 10 ± 2.1%, P < 0.001). In multivariate analysis, both high cholesterol and LDL levels and a high and very high SCORE risk remained significantly associated with the risk of AOEs (P = 0.008; HR = 3.5; 95% CI = 1.4–8.7 and P < 0.001; HR = 4.4; 95% CI = 2–9.8, respectively). Overall, 78 patients (21.1%) presented dyslipidemia at the time of CML diagnosis and 88 (23.3%) after starting nilotinib, but only 26 of them (29.5%) were treated with statins.Low LDL and cholesterol plasma levels are associated with a significant lower risk of AOEs in CML patients treated with nilotinib in the real life.

• Publisher: Springer Nature B.V
• Subject: Cholesterol / Inhibitor drugs / Leukemia / Metabolic disorders / Targeted cancer therapy