Low-density lipoprotein (LDL) levels and risk of arterial occlusive events in chronic myeloid leukemia patients treated with nilotinib

Giovanni Caocci, Olga Mulas, Isabella Capodanno, Massimiliano Bonifacio, Mario Annunziata, Sara Galimberti, Luigiana Luciano, Mario Tiribelli, Bruno Martino, Fausto Castagnetti, Gianni Binotto, Patrizia Pregno, Fabio Stagno, Elisabetta Abruzzese, Monica Bocchia, Antonella Gozzini, Francesco Albano, Claudio Fozza, Debora Luzi, Fabio EfficaceMaria Pina Simula, Luigi Scaffidi, Claudia Baratè, Fiorenza De Gregorio, Rossella Stella, Gabriele Gugliotta, Francesca Pirillo, Malgorzata Monika Trawinska, Anna Sicuranza, Daniele Cattaneo, Immacolata Attolico, Emilia Scalzulli, Alessandra Iurlo, Robin Foà, Massimo Breccia, Giorgio La Nasa

Research output: Contribution to journalArticlepeer-review

Abstract

Recommendations for dyslipidemia management aimed at reducing arterial occlusive events (AOEs) have been recently published. So far, no data have been reported on the management of dyslipidemia in chronic myeloid leukemia (CML) patients treated with nilotinib. We investigated 369 CML adult patients, stratified according to the new Systematic Coronary Risk Evaluation (SCORE) scoring system. Plasma levels of cholesterol, HDL, LDL, and triglycerides were measured prior to the start of nilotinib and after 3, 6, and 12 months. The 5-year cumulative incidence of AOEs was 15.9%. Patients with cholesterol levels > 200 mg/dL and LDL > 70 mg/dL 3 months after treatment showed a significantly higher incidence of AOEs (21.9 ± 4.6% vs 6.2 ± 2.5, P = 0.003). Patients belonging to the high and very high SCORE risk group showed a significant increase of AOEs (34.4 ± 6% vs 10 ± 2.1%, P < 0.001). In multivariate analysis, both high cholesterol and LDL levels and a high and very high SCORE risk remained significantly associated with the risk of AOEs (P = 0.008; HR = 3.5; 95% CI = 1.4–8.7 and P < 0.001; HR = 4.4; 95% CI = 2–9.8, respectively). Overall, 78 patients (21.1%) presented dyslipidemia at the time of CML diagnosis and 88 (23.3%) after starting nilotinib, but only 26 of them (29.5%) were treated with statins. Low LDL and cholesterol plasma levels are associated with a significant lower risk of AOEs in CML patients treated with nilotinib in the real life.

Original languageEnglish
JournalAnnals of Hematology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Arterial occlusive event
  • Cholesterol
  • Chronic myeloid leukemia
  • LDL
  • Nilotinib
  • Triglycerides

ASJC Scopus subject areas

  • Hematology

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