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Imatininib and heart failure

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Hello to All

i was diagnosed with CML 5 months ago and have been frequently reading posts in this forum which have been very useful in coming to terms with what the condition causes and possible solutions to the side effects of the meds.

I am also currently under investigation over the last 3 years for possible heart related problems as I have a dilated left ventricle and valve regurgitation.  I have been reading that there is evidence to suggest that imatinib may also worsen the condition.  Have any of you come across and research or evidence that may be useful for a better understanding of the problems it may cause.

This question has come about because prior to starting treatment my exercise regime was hard due to breathleness but now it’s got to a level where I’m struggling with walking routes I used to run.  The progression is still going downwards and it’s becoming increasingly worrying.

 

kind regards 

 

Hi Mick,

Many years ago I asked my specialist whether imatinib would have an adverse effect on the heart and he said if one had a previous healthy cardio-vascular system there should be no negative effect but if one had a certain precondition then one should carefully monitor any apparent changes.

In terms of long term safety imatinib has been described as the " most extensive" of all the tkis.In terms of alternatives nilotinib has been described as "hard on the heart" and it is recommended that prior to treatment that one has monitoring and at least an ECG plus ongoing checks of the QT interval and the condition of atrial fibrilation.There may be emerging long term matters of toxicity associated with nilotinib in terms of cardio vascular issues and I suggest that you would need to seek the expert advice of your haematologist and a cardiologist if one had a pre existing heart condition.We are told that dasatinib has a one in five possibility of higher grade side effects of pleural effusions and if one has a previous lung or respiratory problem then it might not be advisable to be prescribed this tki.All tkis have side effects and for instance the last line one ponatinib seems to create some challenging vascular events;bosutinib might raise blood sugar levels and affect hypertension levels.

As you have been on the drug imatinib for a short period of time there is little possibility for dose reduction or discontinuation and all the alternatives might have more challenging side effects.If you are not experiencing any other side effects from your imatinib medication then I would be inclined to stick with the drug that you know but at the same time seek further professional medical opinion regarding your situation regarding whether the drug is contributing to your apparent deterioration of breathing etc or whether this might be an independent and largely unrelated condition.

Other forum members may well have an opinion.

With best wishes

John

Thanks for the reply John 

thats pretty much what I have learned from the various sources I have found on the web.  Always better though to get it from people who have similar experience.

im having all the side effects that most in this forum are experiencing, some are more tolerable than others!  My dosage was dropped from 400 to 300mg due to really bad depression, hasn’t entirely gone away but for now it’s manageable. 

I have an echocardiogram arranged in January to see if there has been any further detrimental changes.  I’m hoping it’s not drug related because at the rate of decline in exercise capacity I’m experiencing I hate to think where it’s going to be in s few more years! 

Regards

Mick