Cardiovascular Damage Induced by Anti-BCR-ABL TKIs

  • Giuseppina Novo
  • Daniela Di Lisi
  • Manuela Fiuza
  • Fausto J. Pinto
Part of the Current Clinical Pathology book series (CCPATH)


Anti-BCR-ABL TKIs (tyrosine kinase inhibitors) are drugs that inhibit BCR ABL tyrosine. They are used especially in the treatment of hematological cancer and gastrointestinal stromal tumors (GIST). Anti-BCR-ABL TKIs include first (imatinib), second (nilotinib, dasatinib, bosutinib) and third-generation drugs (ponatinib). Especially second- and third-generation drugs can cause cardiovascular complications such as arterial thrombosis, myocardial ischemia, peripheral arterial diseases, QTc prolongation, and pulmonary hypertension. Nilotinib and ponatinib can cause thrombotic arterial events with various mechanisms. Particularly dasatinib can cause pulmonary hypertension. Compared to conventional chemotherapy, myocardial dysfunction was found in a smaller number of cases. In this chapter, we will illustrate cardiovascular adverse effects induced by anti-BCR-ABL TKIs, the main mechanisms that could explain such effects, and the influence played by cardiovascular risk factors. It is essential for both cardiologists and oncologists to know these issues in order to develop appropriate monitoring and apply preventive strategies to avoid the occurrence of toxicity and the need of any premature interruption of the antineoplastic treatment.


Anti-BCR-ABL Nilotinib Ponatinib Imatinib Dasatinib Tyrosine kinase inhibitors Cardiotoxicity Cardioncology 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Giuseppina Novo
    • 1
  • Daniela Di Lisi
    • 1
  • Manuela Fiuza
    • 2
  • Fausto J. Pinto
    • 2
  1. 1.Division of Cardiology, Biomedical Department of Internal Medicine and Specialities (DIBIMIS), University of PalermoPalermoItaly
  2. 2.Department of CardiologyUniversity Hospital Santa Maria, CHLN University of LisbonLisbonPortugal

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