Effect of Tyrosine Kinase Inhibitor Therapy on Estimated Glomerular Filtration Rate in Patients with Chronic Myeloid Leukemia

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2024-04, Vol.24 (4), p.232-239
• Main Authors: Sönmez, Özge, Özgür Yurttaş, Nurgül, İhtiyaroğlu, İlker, Çakır, Halil Mete, Atlı, Zeynep, Elverdi, Tuğrul, Salihoğlu, Ayşe, Seyahi, Nurhan, Ar, Muhlis Cem, Öngören, Şeniz, Başlar, Zafer, Soysal, Teoman, Eşkazan, Ahmet Emre
• Format: Article
• Language: English
• Subjects: Aged; Chronic kidney disease; Chronic myeloid leukemia; CML; Dasatinib - adverse effects; Glomerular Filtration Rate; Humans; Hypertension; Imatinib; Imatinib Mesylate; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Protein Kinase Inhibitors - adverse effects; Renal Insufficiency, Chronic - etiology; Retrospective Studies; Tyrosine Kinase Inhibitors
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/j.clml.2023.12.004

•Estimated glomerular filtration rate (eGFR) of patients with chronic myeloid leukemia (CML) receiving tyrosine kinase inhibitor (TKI) tended to decline.•Decreases in eGFR among patients with CML and chronic kidney disease (CKD) were comparable during follow-up.•Age, duration of TKI therapy, and hypertension were risk factors in terms of decline in eGFR. Furthermore, lower baseline eGFR was associated with CKD development.•Kidney function deterioration is less frequently observed in patients receiving dasatinib and nilotinib.•Close renal function monitoring is important during TKI treatment. The advent of tyrosine kinase inhibitors (TKIs) was revolutionary in the management of chronic myeloid leukemia (CML). Although TKIs were generally considered to be safe, they can be associated with renal injury. We evaluated the effect of TKIs on renal functions in a cohort of patients with long-term follow-up. We retrospectively examined patients with chronic phase CML treated with TKIs. We analyzed the estimated glomerular filtration rate (eGFR) of patients from the initiation of TKI to the last follow-up. eGFR values of CML patients were compared to those of patients with stage 1 or 2 chronic kidney disease (CKD). A total of 195 patients with CML and 138 patients with CKD were examined. eGFR decline was 1.556 ml/min/1.73m2/year for patients with CML (P = .221). Patients receiving second-generation TKIs (2GTKI) were estimated to have 0.583 ml/min/1.73m2 higher eGFR value than that of the imatinib group, but it was not significant (P = .871). eGFR of patients who had used bosutinib had a downward trend. Duration of TKI therapy, age, and hypertension were found to be significant factors in eGFR decline for CML patients. Lower baseline GFR was associated with an increased risk of CKD development. Imatinib could result in a decline in eGFR which was clinically similar to early-stage CKD patients. We did not observe significant kidney function deterioration in patients receiving 2GTKIs including dasatinib and nilotinib. We recommend close renal function monitoring in patients receiving imatinib, especially for elderly patients with lower baseline eGFR and hypertension. In this study, we evaluated the possible kidney toxicity of tyrosine kinase inhibitors (TKIs) in patients with chronic myeloid leukemia (CML). We examined 195 patients with CML and 138 patients with chronic kidney disease (CKD). We found a downward trend in the glomerular filtration rate under TKI treatmen