Arterial occlusive events in CML patients on TKIs: a real-world study including a large proportion of older patients

The prognosis of chronic myeloid leukemia (CML) has greatly improved with the introduction of tyrosine kinase inhibitors (TKIs), but the high incidence of cardiovascular events, including arterial occlusive events (AOEs), has raised significant concerns. To better understand such adverse events, we analyzed patient comorbidities and TKI prescribing patterns to report safety information including AOE incidence rates for each TKI, time to first recorded AOE, and risk factors for AOEs by treatment line. We used logistic regression analysis with real-world data from a large cohort of 2113 CML patients treated with TKIs to identify risk factors for AOEs by treatment line. The proportions of patients with AOEs increased with each successive treatment line (8.5% for first-line, 12.5% for second-line, and 14.7% for third-line). In the multivariate model, age, sex, dyslipidemia, and hypertension were associated with AOEs in first-line treatment; age and hypertension in second-line treatment; and diabetes in third-line treatment. These results suggest that early therapeutic intervention may be beneficial to prevent AOEs in CML patients with these risk factors.