The Association of Tyrosine Kinase Inhibitors with Obesity in Chronic Myeloid Leukemia

Background: Tyrosine kinase inhibitors (TKIs) have improved survival in patients with chronic myeloid leukemia (CML). Despite the major prognostic benefits of TKIs, there are a range of endometabolic out- comes that may be impacted by their off-target effects, including obesity (Body Mass Index (BMI...

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Bibliographic Details
Published in:	Obesity (Silver Spring, Md.) Vol. 29; p. 172
Main Authors:	Rajan, Raeesha, Karia, Esha, Samaan, M Constantine, Balakumaran, Janatani, Golemiec, Breanne, Spatafora, Laura, Banfield, Laura, Athale, Uma, Thabane, Lehana, Fleming, Adam
Format:	Journal Article
Language:	English
Published:	Silver Spring Blackwell Publishing Ltd 01-12-2021
Subjects:	Body mass index Leukemia Obesity
Online Access:	Get full text
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Summary:	Background: Tyrosine kinase inhibitors (TKIs) have improved survival in patients with chronic myeloid leukemia (CML). Despite the major prognostic benefits of TKIs, there are a range of endometabolic out- comes that may be impacted by their off-target effects, including obesity (Body Mass Index (BMI) > 30 kg/m2). This systematic review assessed the association between TKIs and obesity in CML patients. Methods: Literature searches were conducted in multiple databases up to October 2020. Eligible studies included male and female CML patients > 18 years of age receiving TKIs. We used GRADE to assess the quality of evidence. Results: Eight studies reported BMI data in adults with CML on TKI therapy, including Imatinib, Dasatinib, Nilotinib and Ponatinib used over 0.1-165.6 months. Five studies reported pre-trial BMI only, and were not analyzed further. Two before-and-after studies investigating the effects of Nilotinib reported a non-significant trend on lowering BMI. These studies reported only median and range values, which precluded ascertain- ment of how many patients developed obesity with treatment. One before-and-after study reported individual BMI data in adults with type 2 diabetes and CML (n = 4), receiving Imatinib treatment. Baseline BMI was 38.4 ± 3.59 kg/m2, and follow-up BMI was 36.43 ± 5.79. All participants maintained their BMI at similar levels after treatment. The quality of the evidence using GRADE was very low. Conclusions: Limited evidence suggests that TKIs do not appear to impact BMI in adults with CML on TKI therapy. However, the high heterogeneity, small sample size, and low quality of evidence suggests a need for longitudinal studies on obesity in CML patients to determine the trajectory of BMI changes with TKI therapy.
ISSN:	1930-7381 1930-739X