(HealthDay News) -- Tyrosine kinase inhibitors (TKIs) appear to be safe in patients with chronic-phase (CP) chronic myeloid leukemia (CML) and chronic kidney disease (CKD), according to a study published online in Cancer.

Musa Yilmaz, M.D., from the Baylor College of Medicine in Houston, and colleagues examined the incidence of acute kidney injury (AKI) and CKD in 468 newly diagnosed imatinib-, dasatinib-, and nilotinib-treated CP CML patients. From the start of therapy to the last follow-up, the authors assessed molecular and cytogenetic response data, creatinine, and glomerular filtration rate (GFR).

The researchers found that 4% of patients had TKI-linked AKI. Compared with dasatinib and nilotinib, imatinib correlated with increased incidence of AKI (P = 0.014). Fourteen percent of patients developed CKD while receiving a TKI, of whom 84% were receiving imatinib (P < 0.001). The development of CKD correlated with imatinib, age, history of hypertension, and diabetes mellitus. Imatinib reduced GFR over time in patients with no CKD at baseline, while in patients with a history of CKD, imatinib did not cause a significant decline in GFR. After 3 months of treatment, imatinib, dasatinib, and nilotinib increased the mean GFR, with the most significant increase for nilotinib (P < 0.001).

"The administration of TKIs may be safe in the setting of CKD in CP CML patients, but close monitoring is still warranted," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Source

1. Yilmaz, M; Lahoti, A; O'Brien, S; et al. Cancer; doi: 10.1002/cncr.29587.

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By Phil Coleman

Last updated at 11:45, Monday, 03 August 2015

Medics at the Cumberland Infirmary in Carlisle have treated a patient who picked up a rare form of the E.coli bug while having dialysis in Egypt.

A report on the man’s condition presented to senior managers at the hospital trust which treated him reveals that medics believe he caught the bug during a trip to the North African country in December last year.

None of his contacts was found to have caught the infection and the national watchdog Public Health England (PHE) has been told which dialysis centre in Egypt was involved.

The bug – known as CPE – was one of a number discussed in a report considered by the board of North Cumbria University Hospitals NHS Trust, which runs both the infirmary and Whitehaven’s West Cumbria Hospital.

The report goes on to mention other infections which have been dealt with by the trust’s two hospitals – including nine cases of the bug C-diff, six at the Cumberland Infirmary and three at the West Cumberland.

During 2014-15, says the report, there were 120 patients across north Cumbria with C-diff, and of these 19 died within 30 days of diagnosis.

Between April and June, there were 31 patients affected by the bug, and four of these died within 30 days.

PHE and the Lancashire Health Protection team confirmed that they were involved in investigating a case of CPE at North Cumbria University Hospitals NHS Trust.

Their investigation began in April and centred on Cumberland Infirmary and Whitehaven’s West Cumberland Hospital after routine testing uncovered the bug.

In line with national guidelines, people who may have come into contact with the patient were traced and no other cases were detected.

CPE belongs to a group of bacteria normally found in humans and animal guts. However if they enter blood or the urinary tract, they can cause very serious infections, said the statement. This can occur after an injury or via the use of medical devices such as catheters or intravenous drips where the skin is punctured.

CPE is the name given to gut bacteria which have developed resistance to an important group of antibiotics called Carbapenems. Infections caused by these CPE bacteria can still be treated with antibiotics but this is more difficult and may require combinations of drugs or use of older antibiotics.

Although some people can have active infection, others may carry the bacteria but have no symptoms. This bacteria can spread through faecal contamination so it is very important to practise good hand hygiene to stop it spreading to other vulnerable people. The incident was closed in June 2015.

First published at 11:43, Monday, 03 August 2015
Published by http://www.newsandstar.co.uk

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