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Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
Risk of retinal vein occlusions in patients taking systemic tyrosine kinase inhibitors
Nitesh Mohan1,2, Sunil K Srivastava1, Chandni Duphare1
1Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
Objective:
To describe a series of patients who developed retinal vein occlusion (RVO) while undergoing treatment with tyrosine kinase inhibitors (TKIs) for systemic malignancy.
Methods:
A retrospective chart review was performed to identify patients at an academic medical centre from 2014 to 2024 who developed an RVO while on TKI therapy. Data collected included demographics, cancer diagnosis, TKI agent and treatment duration, ocular history, and treatment outcomes. Ophthalmic imaging obtained at the time of presentation was reviewed when available to confirm the diagnosis of an RVO.
Results:
Eleven patients (12 eyes) were identified with an RVO during TKI therapy. The mean age at presentation was 75.9 ± 9.8 years, and 8 patients (72.7%) were male. TKIs included imatinib (n = 3), axitinib (n = 5), ibrutinib (n = 2), and regorafenib (n = 1). RVO developed after a mean duration of 2.8 ± 2.0 years on TKI therapy (range: 0.8-6.5 years). Of the 12 RVOs, 8 were central retinal vein occlusions (CRVOs) and 4 were branch retinal vein occlusions (BRVOs). The mean Naranjo Adverse Drug Reaction Probability Score was 5.2, suggesting a probable link between TKI use and RVO. One patient developed bilateral RVO after continuing regorafenib therapy.
Conclusions:
This series highlights a possible association between TKI therapy and RVO, underscoring the need for awareness in patients with vascular risk factors.
Insights
This study found a probable link between tyrosine kinase inhibitor (TKI) therapy and retinal vein occlusion (RVO). Patients on TKIs, especially those with vascular risk factors, require careful monitoring for RVO development.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Tyrosine kinase inhibitors (TKIs) are crucial in treating systemic malignancies.
- Retinal vein occlusion (RVO) is a serious ocular vascular event.
- The potential ocular side effects of TKIs warrant investigation.
Purpose of the Study:
- To investigate the occurrence of RVO in patients undergoing TKI therapy for cancer.
- To identify characteristics and outcomes of RVO in this patient cohort.
Main Methods:
- Retrospective chart review of patients treated with TKIs from 2014-2024.
- Data collection included demographics, cancer type, TKI details, ocular history, and outcomes.
- Ophthalmic imaging was reviewed to confirm RVO diagnoses.
Main Results:
- Eleven patients (12 eyes) developed RVO during TKI treatment.
- Common TKIs involved were imatinib, axitinib, ibrutinib, and regorafenib.
- The mean Naranjo score suggested a probable association between TKI use and RVO.
Conclusions:
- A potential association exists between TKI therapy and the development of RVO.
- Increased awareness is crucial for patients on TKIs, particularly those with existing vascular risk factors.
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