{Reference Type}: Journal Article
{Title}: Impact of Tyrosine Kinase Inhibitors (TKIs) on Growth in Children and Adolescents with Chronic Myeloid Leukemia: A Systematic Review.
{Author}: Katsarou D;Kotanidou EP;Tsinopoulou VR;Tragiannidis A;Hatzipantelis E;Galli-Tsinopoulou A;
{Journal}: Curr Pharm Des
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 12
{Factor}: 3.31
{DOI}: 10.2174/0113816128309071240626114308
{Abstract}: <B>BACKGROUND: </B>Chronic Myeloid Leukemia (CML) is a rare myeloproliferative disease in childhood. Treatment in CML includes Tyrosine Kinase Inhibitors (TKI's), which inhibit the cytoplasmic kinase BCR/ABL. Tyrosine kinases play a key role in the secretion of growth hormone and insulin-like growth factor1 (IGF-1).<BR><B>OBJECTIVE: </B>The aim of this systematic review was to study the effect of TKIs on the growth of children and adolescents with CML.<BR><B>METHODS: </B>English-language publications were searched in the PubMed/Cochrane library/Google Scholar databases (2002-2023), and retrieved studies were assessed according to PRISMA-Statement and Newcastle- Ottawa-scale.<BR><B>RESULTS: </B>The search strategy yielded 1066 articles. After applying the inclusion/exclusion criteria, 941 were excluded based on title screening and 111 on abstract review. The systematic review included 14 articles (11 retrospective observational studies/3 clinical trials). Twelve studies reported data on the prevalence of growth disorders after the administration of 1st generation TKIs (imatinib). Two studies reported a negative effect of 2nd generation TKIs (dasatinib/nilotinib) on physical growth. Four studies recorded a decrease in height z-score after treatment compared to baseline. Two 1st-generation TKIs studies reported data on children's final height; one reported restoration of final height to normal after the onset of puberty, despite initial slowing, and the final height was lower than mid-parental target height. Serum IGF-1 levels were reported in 2 studies to be within normal range, while in 3 studies, a significant decrease was documented. Considerable study heterogeneity was observed related to dosage/duration of treatment/disease phase/stage of puberty/ethnicity.<BR><B>CONCLUSIONS: </B>A negative effect of TKIs on the growth and final height of children was noted.