Tyrosine Kinase Inhibitor Therapies in Chronic Myeloid Leukemia: Effects on Clinical Characteristics and Triglyceride‑to‑High Density Lipoprotein Cholesterol Ratio

Abstract

Background and Aim: Tyrosine kinase inhibitors (TKIs) have dramatically improved chronic myeloid leukemia (CML) prognosis. However,  TKIs are associated with dyslipidemia and impaired glucosehomeostasis. Triglyceride-to-high-density lipoprotein cholesterol  ratio (TG/HDL-C) is proposed to be an indicator of insulin resistance and atherogenic index, but there is no research on TG/HDL‑C  alterations in patients receiving TKIs for CML. We aimed to evaluate relationships between TKI type/count, clinical characteristics, and  laboratory results (particularly TG/ HDL-C) in CML patients.

Patients and Methods: A total of 104 patients with chronic phase CML were  enrolled in the study. All patients received initial imatinib therapy at 400 mg daily, the type or dose of TKI was then changed according to treatment response and clinical outcomes. Patients were compared with respect to TG/HDL-C categorization (>2.5 versus <2.5), number  of TKIs used, and use of imatinib as the only TKI.

Results: The median TG/HDL-C was 2.82 (1.03–17.33) and this ratio was higher than 2.5  in 59 (56.7%) patients. Patients with high TG/ HDL‑C had a significantly higher age than patients with low values (P < 0.001). Recipients of  more than one TKI had higher EUTOS risk score and white blood cell (WBC) count (P < 0.05). Recipients of imatinib as the only TKI had  higher age, low EOTUS risk score, low WBC, and low neutrophil count (all, P < 0.05).

Conclusion: TG/HDL‑C values were not associated  with the number of different TKIs used or the use of imatinib only in chronic‑phase patients with CML. Further large-scale prospective  studies are needed to determine whether TG/HDL-C can be used for diagnostic or prognostic purposes in TKI recipients.