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Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib
BACKGROUND: Nilotinib, a second-generation BCR-ABL tyrosine kinase inhibitor (TKI), is highly effective in the treatment of patients with chronic myeloid leukemia (CML), despite being more vasculotoxic than older TKIs such as imatinib. Herein, we present a case of nilotinib-associated vasospastic an...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393793/ https://www.ncbi.nlm.nih.gov/pubmed/34452646 http://dx.doi.org/10.1186/s40959-021-00119-6 |
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author | Maruta, Shunsuke Usami, Kyohei Tajiri, Kazuko Otani, Masafumi Hiraya, Daigo Watabe, Hiroaki Hoshi, Tomoya Sato, Akira Ieda, Masaki |
author_facet | Maruta, Shunsuke Usami, Kyohei Tajiri, Kazuko Otani, Masafumi Hiraya, Daigo Watabe, Hiroaki Hoshi, Tomoya Sato, Akira Ieda, Masaki |
author_sort | Maruta, Shunsuke |
collection | PubMed |
description | BACKGROUND: Nilotinib, a second-generation BCR-ABL tyrosine kinase inhibitor (TKI), is highly effective in the treatment of patients with chronic myeloid leukemia (CML), despite being more vasculotoxic than older TKIs such as imatinib. Herein, we present a case of nilotinib-associated vasospastic angina confirmed by an acetylcholine spasm provocation test. CASE PRESENTATION: A 62-year-old CML patient treated with 300 mg nilotinib twice daily complained of several episodes of rest angina and was hospitalized at our institution. Coronary angiography revealed no severe organic stenosis, and the acetylcholine spasm provocation test confirmed the diagnosis of vasospastic angina. Although treatment with a calcium channel blocker and nicorandil reduced the frequency of chest pain, angina symptoms continued to occur. At 10 months post discharge, the patient complained of increased frequency of angina; therefore, the nilotinib dosage was reduced to 150 mg twice daily. Consequently, the patient reported a significant improvement in chest symptoms. CONCLUSIONS: This case report highlights the potential vasculotoxic effects of nilotinib. Cardiologists and hematologists should be vigilant for coronary artery spasm as a possible vascular adverse event caused by nilotinib. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40959-021-00119-6. |
format | Online Article Text |
id | pubmed-8393793 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83937932021-08-30 Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib Maruta, Shunsuke Usami, Kyohei Tajiri, Kazuko Otani, Masafumi Hiraya, Daigo Watabe, Hiroaki Hoshi, Tomoya Sato, Akira Ieda, Masaki Cardiooncology Case Report BACKGROUND: Nilotinib, a second-generation BCR-ABL tyrosine kinase inhibitor (TKI), is highly effective in the treatment of patients with chronic myeloid leukemia (CML), despite being more vasculotoxic than older TKIs such as imatinib. Herein, we present a case of nilotinib-associated vasospastic angina confirmed by an acetylcholine spasm provocation test. CASE PRESENTATION: A 62-year-old CML patient treated with 300 mg nilotinib twice daily complained of several episodes of rest angina and was hospitalized at our institution. Coronary angiography revealed no severe organic stenosis, and the acetylcholine spasm provocation test confirmed the diagnosis of vasospastic angina. Although treatment with a calcium channel blocker and nicorandil reduced the frequency of chest pain, angina symptoms continued to occur. At 10 months post discharge, the patient complained of increased frequency of angina; therefore, the nilotinib dosage was reduced to 150 mg twice daily. Consequently, the patient reported a significant improvement in chest symptoms. CONCLUSIONS: This case report highlights the potential vasculotoxic effects of nilotinib. Cardiologists and hematologists should be vigilant for coronary artery spasm as a possible vascular adverse event caused by nilotinib. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40959-021-00119-6. BioMed Central 2021-08-27 /pmc/articles/PMC8393793/ /pubmed/34452646 http://dx.doi.org/10.1186/s40959-021-00119-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Maruta, Shunsuke Usami, Kyohei Tajiri, Kazuko Otani, Masafumi Hiraya, Daigo Watabe, Hiroaki Hoshi, Tomoya Sato, Akira Ieda, Masaki Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
title | Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
title_full | Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
title_fullStr | Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
title_full_unstemmed | Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
title_short | Vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
title_sort | vasospastic angina in a chronic myeloid leukemia patient treated with nilotinib |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393793/ https://www.ncbi.nlm.nih.gov/pubmed/34452646 http://dx.doi.org/10.1186/s40959-021-00119-6 |
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