Clinical trials of medications generally exclude people with medical conditions other than the condition being studied, so little is known about whether these treatments are safe in a wide range of people. This issue is especially important in CML, because the disease affects older people who are more likely to have other medical problems.
A new study has looked at the safety of starting treatment with Sprycel or Tasigna in people with liver or kidney disease (Sasaki and colleagues. Clin Lymphoma Myeloma Leuk 2015; epublished December 183 2015). The liver and kidney are important because these organs are largely responsible for metabolizing medications and eliminating them from the body. People with liver or kidney dysfunction can be at risk of drug toxicities because the body can’t process the drug or eliminate it. Conversely, medications themselves have the potential to cause liver or kidney damage and can worsen a pre-existing problem.
The study looked at 215 people with and without liver or kidney disease who started treatment with either Sprycel or Tasigna for their CML. The two treatments were associated with some acute kidney injury, but this was reversible. No liver damage was reported.
Importantly, people with some degree of liver or kidney dysfunction were able to achieve similar rates of complete cytogenetic response (CCyR), major molecular response (MMR), or deep molecular response (a 4.5-log reduction or greater) compared to those without liver/kidney disease. So liver or kidney problems did not appear to impede the action of these medications.
These results suggest that people with liver or kidney disease who develop CML can be successfully treated with Sprycel or Tasigna. Your doctor will need to closely monitor your liver and kidney function (e.g. with blood tests and urinalysis) of course to ensure that no other medical problems develop while treating your CML.