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Malhotra A, Gupta R, Mahajan S. Tyrosine kinase inhibitors induced thyroid dysfunction: myth or reality? Rep Pract Oncol Radiother 2023; 28:463-467. [PMID: 37795229 PMCID: PMC10547422 DOI: 10.5603/rpor.a2023.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/19/2023] [Indexed: 10/06/2023] Open
Abstract
Background Chronic myelogenous leukemia (CML) is a hematopoietic stem cell disorder. It is associated with acquired genetic changes in the hematopoietic stem cells in the form of BCR-ABL fusion gene also known as Philadelphia chromosome. Materials and methods We prospectively studied thyroid function at baseline and at 6 months of imatinib treatment in 26 newly diagnosed BCR-ABL positive CML patients. Result The thyroid-stimulating hormone (TSH) levels increased significantly from baseline (3.20 ± 0.978 mIU/L vs. 3.724 ± 1.726 mIU/L, p < 0.05) after 6 months of treatment, 88.4% of the patients remained euthyroid. Only 2 patients had subclinical hypothyroidism, 1 had hypothyroidism after 6 months of tyrosine kinase inhibitors (TKI) therapy. Conclusion Imatinib did not have any significant effect on thyroid function in CML patients in this study.
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Affiliation(s)
- Anjli Malhotra
- Department of Medicine, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Rajeev Gupta
- Department of Medicine, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Shveta Mahajan
- Dental Surgeon, PHC Lakhanpur, Directorate of Health Services Jammu UT (J&K), India
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Rodia R, Pani F, Caocci G, La Nasa G, Simula MP, Mulas O, Velluzzi F, Loviselli A, Mariotti S, Boi F. Thyroid autoimmunity and hypothyroidism are associated with deep molecular response in patients with chronic myeloid leukemia on tyrosine kinase inhibitors. J Endocrinol Invest 2022; 45:291-300. [PMID: 34283388 PMCID: PMC8783879 DOI: 10.1007/s40618-021-01613-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/13/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Thyroid alterations including de novo appearance of thyroid autoimmunity are adverse effects of tyrosine kinase inhibitors, used in solid and hematologic cancer therapy, but the relationship between thyroid alterations during this treatment and the outcome of chronic myeloid leukemia remains unclear. Aim of this study was to investigate whether the presence of thyroid alterations may affect the clinical outcome of chronic myeloid leukemia on tyrosine kinase inhibitors. METHODS We evaluated thyroid function and autoimmunity in 69 chronic myeloid leukemia patients on long-term therapy looking at the association between thyroid abnormalities and disease molecular response. RESULTS Overall, 24 of 69 (34.8%) had one or more thyroid abnormalities during therapy. A high percentage of patients (21/69, 30.4%) showed thyroid autoimmunity (positive thyroid autoantibodies with ultrasound hypoechogenicity), while clinical and subclinical hypothyroidism and subclinical hyperthyroidism were, respectively, found in 4 of 69 (5.8%) and 3 of 69 (4.3%) of cases. Second-generation tyrosine kinase inhibitors resulted significantly associated (14/32, 43.7%) with Hashimoto's thyroiditis, compared to first generation (7/37, 18.9%; p = 0.03). Interestingly, we also found a significant association between euthyroid (14/26, 53.8%) and hypothyroid Hashimoto's thyroiditis (4/26, 15.4%) in patients with deep molecular response, as compared to euthyroid (3/43, 7%; p = 0.0001) and hypothyroid (0/43, 0%; p = 0.02) Hashimoto's thyroiditis patients with major molecular response. CONCLUSIONS Our study confirms and extends our knowledge on the tyrosine kinase inhibitors effects on thyroid, showing that thyroid autoimmunity is frequently observed in chronic myeloid leukemia patients on long-term therapy and is associated with a better oncological response.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - F Pani
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - G Caocci
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - G La Nasa
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - M P Simula
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - O Mulas
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - A Loviselli
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy.
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