Low impact of cardiovascular adverse events on anagrelide treatment discontinuation in a cohort of 232 patients with essential thrombocythemia

Luigi Gugliotta, Alessia Tieghi, Giovanni Tortorella, Potito Rosario Scalzulli, Rosanna Ciancia, Monia Lunghi, Emma Cacciola, Rossella Cacciola, Anna Candoni, Monica Crugnola, Katia Codeluppi, Emilio Usala, Giorgina Specchia, Vincenzo Martinelli, Fausto Palmieri, Ivana Pierri, Anna Marina Liberati, Alessandra Iurlo, Alberto Grossi, Alessandro M. VannucchiNicola Vianelli, Maria Gabriella Mazzucconi

Research output: Contribution to journalArticlepeer-review

Abstract

This retrospective study of the thrombocythemia Italian registry (RIT) documented that 71 (30.6%) out of 232 ET patients experienced 88 cardiovascular adverse events (CV-AEs) during anagrelide treatment (522 pt-y). The rate of CV-AEs was: 24.1% for palpitations, 4.3% for angina, 3.5% for arterial hypertension, 3.0% for congestive heart failure, 1.8% for arrhythmia, 0.9% for AMI, 0.4% for pericardial effusion. CV-AEs led to treatment discontinuation in nine (3.9%) patients, while in the remaining cases they were managed by pharmacological intervention and/or patient life style improvement. CV-AEs had no relationship with patient characteristics (including older age). A significant relationship was found only with a higher anagrelide induction dose.In the absence of any agreed protocol, a cardiovascular instrumental evaluation (CV-IE) was performed in 102 (44%) patients before commencement of anagrelide (with higher rate after the anagrelide/Xagrid EMA approval of 2004), and in 84 (36%) patients during treatment. Patients with and without CV-IEs, who resulted completely balanced for all their characteristics, did not significantly differ in the occurrence of CV-AEs.In conclusion, this study on ET patients treated with anagrelide shows that CV-AEs, equally distributed in younger and older subjects, were mostly mild and easily manageable, allowing safe treatment continuation in the majority of cases. Moreover, routinely performing a CV-IE did not appear to anticipate the occurrence of CV-AEs.

Original languageEnglish
Pages (from-to)1557-1563
Number of pages7
JournalLeukemia Research
Volume35
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Anagrelide
  • Cardiovascular adverse events
  • Echocardiogram
  • Essential thrombocythemia
  • Palpitation
  • Safety
  • Toxicity

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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