Changes in laboratory indicators of endothelial dysfunction and lipid spectrum in patients with chronic myeloid leukemia treated with the second-generation tyrosine kinase inhibitor bosutinib

The purpose of the study. To determine changes in the concentration of endothelial dysfunction markers and the lipid spectrum in patients with chronic myeloid leukemia who receive the second-generation tyrosine kinase inhibitor bosutinib.

Materials and methods. Using a continuous sampling method, the study included 47 patients with a diagnosis of chronic myeloid leukemia, chronic phase, who were transferred to line II therapy. The lipid spectrum indicators, as well as the levels of endothelin-1, vascular endothelial growth factor, and homocysteine, were evaluated using an enzyme-linked immunosorbent assay.

Results. The level of C-reactive protein did not change. In 8 (17.02%) patients, an increase in the level of endothelin-1 was detected (17.23 (15.56;21.02) before therapy versus 72.16 (67.35;80.83) pg/ml, p<0.001), vascular endothelial growth factor (88.81 (78.99;96.46) before therapy versus 623.35 (612.56;650.36) pg/mlml, p<0.001) and homocysteine (186.64 (169.21;214.64) before therapy versus 691.54 (650.65;740.36) ng/ml, p<0.001) by month 12 of bosutinib therapy. After 12 months, correlations were found for OH with VEGF (rxy=0.659, p<0.001), with ET-1 (rxy=0.423, p=0.013), with homocysteine (rxy =0.553, p=0.001), and LDL cholesterol with VEGF (rxy=0.396, p=0.020), with ET-1 (rxy=0.360, p=0.036), with homocysteine (rxy =0.403, p=0.018).

Conclusions. The obtained data show a significant endothelial dysfunction in patients with chronic myeloid leukemia receiving the second-generation tyrosine kinase inhibitor bosutinib at a dose of 500 mg, manifested in an increase in the levels of endothelin-1, vascular endothelial growth factor, and homocysteine, as well as in the lipid spectrum indicators by the 12th month of treatment, which requires long-term monitoring of patients in order to prevent cardiovascular diseases in oncohematological patients.

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