Abstract：
BACKGROUND: Tyrosine kinase inhibitors (TKI), such as Dasatinib, are effective in the treatment of chronic myeloid leukemia (CML) but associated with development of pleural effusions (PE). The relationship between haemodynamic parameters identified on transthoracic echocardiogram (TTE) such as elevated estimated left atrial pressure (LAP), and PE development is unknown. This study aims to describe associations between Dasatinib, elevated LAP and PE.
METHODS: This was a retrospective study of 71 CML patients who underwent TTE during treatment with various TKIs. Descriptive analysis was performed to identify associations between TKI use, PE and elevated LAP on TTE. Multivariate logistic regression was performed to identify predictors of elevated LAP.
RESULTS: There were 36 patients treated with Dasatinib, 15 Nilotinib, and 20 Imatinib. Those treated with Dasatinib had higher rates of elevated LAP (44% vs 7% Nilotinib vs 10% Imatinib, p < 0.01) and PE (39% vs 7% vs 0%, p < 0.01). In the 15 patients who developed PE, 14 (93%) patients were treated with Dasatinib. Patients with PE had higher rates of elevated LAP (67% vs 16%, p < 0.01). Nineteen (26.8%) patients in the entire cohort had elevated LAP. After multivariate adjustment, Dasatinib (OR 33.50, 95% CI = 4.99-224.73, p < 0.01) and age (OR 1.12, 95% CI = 1.04-1.20, p < 0.01) were associated with elevated LAP.
CONCLUSIONS: Among patients with CML, there was an association between Dasatinib use, PE and elevated LAP on TTE. These findings are hypothesis generating and further studies are required to evaluate the utility of elevated LAP on TTE as a novel marker for prediction and surveillance of PE.
METHODS: This was a retrospective study of 71 CML patients who underwent TTE during treatment with various TKIs. Descriptive analysis was performed to identify associations between TKI use, PE and elevated LAP on TTE. Multivariate logistic regression was performed to identify predictors of elevated LAP.
RESULTS: There were 36 patients treated with Dasatinib, 15 Nilotinib, and 20 Imatinib. Those treated with Dasatinib had higher rates of elevated LAP (44% vs 7% Nilotinib vs 10% Imatinib, p < 0.01) and PE (39% vs 7% vs 0%, p < 0.01). In the 15 patients who developed PE, 14 (93%) patients were treated with Dasatinib. Patients with PE had higher rates of elevated LAP (67% vs 16%, p < 0.01). Nineteen (26.8%) patients in the entire cohort had elevated LAP. After multivariate adjustment, Dasatinib (OR 33.50, 95% CI = 4.99-224.73, p < 0.01) and age (OR 1.12, 95% CI = 1.04-1.20, p < 0.01) were associated with elevated LAP.
CONCLUSIONS: Among patients with CML, there was an association between Dasatinib use, PE and elevated LAP on TTE. These findings are hypothesis generating and further studies are required to evaluate the utility of elevated LAP on TTE as a novel marker for prediction and surveillance of PE.
摘要：
背景：酪氨酸激酶抑制剂（TKI），如达沙替尼，对慢性粒细胞白血病（CML）的治疗有效，但与胸腔积液（PE）的发展有关。经胸超声心动图（TTE）确定的血流动力学参数之间的关系，例如升高的估计左心房压（LAP），和PE的发展是未知的。本研究旨在描述达沙替尼之间的关联，升高的LAP和PE。
方法：这是一项对71例CML患者的回顾性研究，这些患者在接受各种TKI治疗期间接受了TTE。进行描述性分析以确定TKI使用之间的关联，PE和TTE上的高架LAP。进行多变量逻辑回归以确定LAP升高的预测因子。
结果：有36例患者接受达沙替尼治疗，15尼洛替尼，和20伊马替尼。接受达沙替尼治疗的患者LAP升高率较高（44％vs7％尼洛替尼vs10％伊马替尼，p<0.01)和PE(39%vs7%vs0%，p<0.01)。在15名发展为PE的患者中，14例（93%）患者接受达沙替尼治疗。PE患者LAP升高率较高（67%vs16%，p<0.01)。整个队列中有19例（26.8%）患者LAP升高。经过多变量调整后，达沙替尼（OR33.50，95％CI=4.99-224.73，p<0.01）和年龄（OR1.12，95％CI=1.04-1.20，p<0.01）与LAP升高相关。
结论：在CML患者中，达沙替尼的使用之间存在关联，PE和TTE上的高架LAP。这些发现是假设的产生，需要进一步的研究来评估TTE上LAP升高作为预测和监测PE的新标记的实用性。
方法：这是一项对71例CML患者的回顾性研究，这些患者在接受各种TKI治疗期间接受了TTE。进行描述性分析以确定TKI使用之间的关联，PE和TTE上的高架LAP。进行多变量逻辑回归以确定LAP升高的预测因子。
结果：有36例患者接受达沙替尼治疗，15尼洛替尼，和20伊马替尼。接受达沙替尼治疗的患者LAP升高率较高（44％vs7％尼洛替尼vs10％伊马替尼，p<0.01)和PE(39%vs7%vs0%，p<0.01)。在15名发展为PE的患者中，14例（93%）患者接受达沙替尼治疗。PE患者LAP升高率较高（67%vs16%，p<0.01)。整个队列中有19例（26.8%）患者LAP升高。经过多变量调整后，达沙替尼（OR33.50，95％CI=4.99-224.73，p<0.01）和年龄（OR1.12，95％CI=1.04-1.20，p<0.01）与LAP升高相关。
结论：在CML患者中，达沙替尼的使用之间存在关联，PE和TTE上的高架LAP。这些发现是假设的产生，需要进一步的研究来评估TTE上LAP升高作为预测和监测PE的新标记的实用性。
