Ponatinib Tyrosine Kinase Inhibitor Induces a Thromboinflammatory Response.

Autor: Hamadi A; Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia., Grigg AP; Department of Clinical Haematology, Austin Hospital, Heidelberg, Victoria, Australia., Dobie G; Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia., Burbury KL; Department of Haematology, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia., Schwarer AP; Department of Haematology, Eastern Health, Box Hill, Victoria, Australia., Kwa FA; Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia., Jackson DE; Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
Jazyk: angličtina
Zdroj: Thrombosis and haemostasis [Thromb Haemost] 2019 Jul; Vol. 119 (7), pp. 1112-1123. Date of Electronic Publication: 2019 May 12.
DOI: 10.1055/s-0039-1688787
Abstrakt: Both nilotinib, a second-generation tyrosine kinase inhibitor (TKI) used in the treatment of chronic myeloid leukaemia (CML), and ponatinib, a third-generation TKI used in CML and Philadelphia positive acute lymphocytic leukaemia, have been associated with an increase in arterial occlusive events, in contrast to other TKIs such as imatinib and dasatinib. We have previously demonstrated evidence of a pro-thrombotic state associated with nilotinib, using microvascular and arterial thrombosis C57BL/6 mouse models. In this study, we examined ponatinib and determined if a calcium channel blocker could ameliorate the pro-thrombotic and pro-inflammatory phenotypes. In vitro treatment of whole human or murine blood with ponatinib and nilotinib increased platelet activation, adhesion and three-dimensional thrombi over time compared with vehicle control or other TKIs. Treatment of wild-type C57BL/6 mice with ponatinib and nilotinib but not imatinib, dasatinib or vehicle control for 4 hours significantly increased thrombus growth following ex vivo perfusion on collagen and FeCl 3 -induced vascular injury of mesenteric arterioles and carotid artery in vivo and increased plasma levels of soluble P-selectin, tumour necrosis factor-α, interleukin-6, interferon-γ and thromboxane B 2 (TxB 2 ). Ponatinib-treated CML patients had increased ex vivo thrombus formation and a pro-inflammatory phenotype compared with healthy controls. Pre-treatment of mice with the calcium channel antagonist, diltiazem, prior to ponatinib or nilotinib reversed the pro-thrombotic phenotype and the increase in cytokine levels. These observations suggest that the pro-thrombotic effect of nilotinib and ponatinib is partially related to calcium channel activation and TxA 2 generation and this should be explored clinically as a mechanism to prevent vascular events.
Competing Interests: None declared.
(Georg Thieme Verlag KG Stuttgart · New York.)
Databáze: MEDLINE
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