Related Experiment Video
Updated: May 5, 2026
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 19, 2013
Practical Management of Cardiovascular Adverse Events with BTKi Treatment in Patients with Chronic Lymphocytic
Talha Munir1, Eglė Čiburienė2, Vasko Graklanov3
1Department of Haematology, Leeds Teaching Hospitals NHS Trust, Leeds, UK, tmunir@nhs.net.
Insights
Managing cardiovascular risks like atrial fibrillation and hypertension is crucial for patients with chronic lymphocytic leukemia (CLL) undergoing Bruton
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Cardiovascular adverse events, including atrial fibrillation and hypertension, are observed in patients treated for chronic lymphocytic leukemia (CLL) with Bruton's tyrosine kinase inhibitors (BTKis).
- Existing guidelines for managing these adverse events show inconsistencies in practical application across different regions and clinical settings.
- There is a need for standardized recommendations to address these management inconsistencies.
Purpose of the Study:
- To develop consensus recommendations for the screening, monitoring, and treatment of atrial fibrillation (AF) and hypertension in patients with CLL receiving BTKi therapy.
- To provide practical guidance for managing cardiovascular toxicities associated with BTKi treatment.
- To ensure the continuity of effective CLL treatment by addressing associated cardiovascular risks.
Main Methods:
- Convening a European expert panel of hematologists and cardiologists.
- Conducting a comprehensive literature analysis.
- Utilizing expert interviews and the Delphi method to achieve consensus on key statements regarding AF and hypertension management.
Main Results:
- Developed consensus statements on screening, monitoring, and treatment strategies for AF and hypertension in CLL patients on BTKi therapy.
- Established a risk-stratification system for cancer therapy-related cardiovascular toxicity (low, moderate, high, very high risk).
- Recommended patient education for symptom monitoring and home-based monitoring of blood pressure and electrocardiograms.
Conclusions:
- Maintaining BTKi treatment is essential for maximizing time to next treatment in CLL patients.
- Appropriate management of hypertension and AF, along with potential BTKi dose adjustments, can help maintain treatment in high-risk patients.
- Close collaboration between hematologists and cardiologists is vital for optimizing patient outcomes and ensuring effective CLL treatment alongside cardiovascular care.
Abstract:
Background: Cardiovascular (CV) adverse events (AEs), especially atrial fibrillation (AF) and hypertension, have been reported in patients receiving treatments for chronic lymphocytic leukemia (CLL), including Bruton's tyrosine kinase inhibitors (BTKis). Although these AEs are managed effectively in most cases and AE management guidelines exist, practical management approaches are inconsistent across regions and practices. We aimed to address these inconsistencies by developing consensus recommendations. Summary: A European expert panel was assembled comprising eight hematologists and six cardiologists. Literature analysis, expert interviews, and the Delphi method were used to gain consensus on screening, monitoring, and treatment of AF and hypertension statements. Key Messages: Maintaining BTKi treatment is paramount to maximize time to next treatment; for patients at high risk of progression, this can be achieved by appropriately treating hypertension and AF and adjusting the BTKi dose. Patients should be risk-stratified as low, moderate, high, or very-high risk of cancer therapy-related CV toxicity and treated according to their disease status so that CLL treatment can be maintained. Patient education on symptom monitoring, home blood pressure monitoring, and electrocardiograms (baseline, every 3 months) are recommended to detect/monitor AF and hypertension. Close collaboration between hematologists and cardiologists is vital to achieve optimal patient outcomes.
.More Related Videos
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
06:08Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model
Published on: February 10, 2023
Related Concept Videos
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
01:14Myocarditis III: Medical Management
01:22Myocarditis IV: Nursing Management
01:21Rheumatic Heart Disease III: Medical Management
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:29Cardiomyopathy V: Interprofessional Care