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Sarlon-Bartoli G, Michel Q, Sarlon E, Carcopino-Tusoli M, Suchon P, Soler R, Bartoli MA, Brunet D, Morange P, Charbonnier A. Ultrasound arterial anomalies in patients exposed to nilotinib therapy for chronic myeloid leukemia. J Med Vasc 2021; 46:66-71. [PMID: 33752848 DOI: 10.1016/j.jdmv.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Patients exposed to nilotinib for chronic myeloid leukemia (CML) appear to be at risk of arterial complication. The prevalence and aspect of ultrasound asymptomatic arterial lesions are unknown. OBJECTIVE To describe prevalence and characteristics of ultrasound arterial anomalies in patients treated with nilotinib for CML. METHODS Patients treated with nilotinib from 2006 to 2015 in the department of the Paoli-Calmettes Institute, Marseille, were included retrospectively. A vascular ultrasound screening was carried out from 2010. The arterial lesions at the first examination were described: plaque and its echogenicity, stenosis or occlusion. A vascular arterial anomaly (VAA) was defined by the presence of a clinical and/or ultrasound anomaly. Patients with or without VAA at initial vascular examination were compared using bivariate and multivariate analysis. RESULTS 74 patients were included (51.4% men, mean age 54.5 years); 25 patients had ultrasound arterial anomalies (33.8%). Carotid bulb was the most involved territory (44%). Arterial anomalies were: 88% plaques, 44%>50% stenosis and 12% occlusion. 72.7% plaques were echolucent or hypoechogenic. A VAA was present in 25 patients with initial vascular evaluation (33.8%). Patients with VAA at baseline were significantly older (64.9 vs 49.3, P<0.001), older at nilotinib initiation (60.8 vs 46.5, P<0.001), with more arterial hypertension (40% vs 12.2%, P=0.01), with more cardiovascular risk factors (P=0.03). In patient with no cardiovascular risk factor 12.5% had VAA (n=24). CONCLUSION Nilotinib seems to be associated to arterial lesions of unstable lipid-like appearance. The most involved arterial territory was the carotid bulb and the most common lesion was echolucent or hypoechogenic plaque. VAA can occur in patients without cardiovascular risk factors. This result encourages us to systematically screen and follow all patients exposed to nilotinib even those without cardiovascular risk factors.
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Affiliation(s)
- G Sarlon-Bartoli
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
| | - Q Michel
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - E Sarlon
- Unité de Santé publique, Centre Hospitalier Intercommunal Gap, 1, place Auguste Muret, 05000 Gap, France
| | - M Carcopino-Tusoli
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - P Suchon
- Service d'hématologie, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - R Soler
- Service de Chirurgie Vasculaire, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - M A Bartoli
- Service de Chirurgie Vasculaire, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - D Brunet
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Service d'hématologie, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - P Morange
- Service d'hématologie, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - A Charbonnier
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Institut Paoli-Calmettes, département d'Onco-hématologie, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France
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Morange P, Cohen W, Charbonnier A, Carcopino-Tusoli M, Brunet D, Barthet M, Soler R, Bartoli M, Bartoli J, Sarlon-Bartoli G. Prévalence des maladies cardiovasculaires chez 42 patients traités par Nilotinib pour une leucémie myéloïde chronique. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.jmv.2014.07.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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