Bone marrow aplasia—a rare complication of imatinib therapy in CML patients

Srinivas, Upendra; Pillai, Lakshmi Sadasivan; Kumar, Rajat; Pati, Haraprasad; Saxena, Renu

doi:10.1002/ajh.20776

Cited by 22 publications

(16 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the majority of subjects, the anemia was normocytic but the concomitant normal values of WBC and PLTs as well as of bilirubin and LDH made it possible to exclude both an aplastic or hemolytic etiology, as previously reported in sporadic previous cases [6][7][8]. In 21% of patients, there were signs of iron deficiency without evidence of blood chronic loss: these subjects received a standard oral iron supplementation but were unresponsive in 7 out 8 cases.…”

Section: Discussionmentioning

confidence: 57%

“…In patients responsive to imatinib, however, it is still unknown whether the long-lasting treatment could induce the appearance of a persistent/ late chronic anemia: only sporadic cases of late aplastic or hemolytic anemia have been reported [6][7][8]. In the real-life setting, however, it is relatively common to observe subjects with a slight reduction in Hb levels, but up to now there is no definite measurement of such phenomenon.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence of persistent/late chronic anemia in newly diagnosed patients with chronic myeloid leukemia responsive to imatinib

Latagliata

Volpicelli²,

Breccia

et al. 2014

American J Hematol

View full text Add to dashboard Cite

In patients with chronic myeloid leukemia (CML) responsive to imatinib, it is still unknown whether the longlasting treatment could induce the appearance of a persistent/late chronic anemia. To highlight this issue, we revised 128 patients with CML (M/F 64/64, median age at diagnosis 56.9 years, interquartile range 43.0-69.3) treated at our Institution with 1st line imatinib for at least 36 months and in stable complete cytogenetic response. At the 36th month of imatinib, a chronic anemia (Hb < 12 g/dl for > 6 months) was present in 38/128 patients (29.6%): the anemia was moderate (Hb > 8 10 g/dl) in 12 patients (9.3%) and mild (Hb > 10 < 12 g/dl) in 26 patients (20.3%). All patients with persistent/late chronic anemia had a low reticulocyte count and 8/38 a condition of iron deficiency without clinical and instrumental signs of chronic blood loss. Four out of 38 patients (10.5%) needed red cell transfusions during the follow-up. At a landmark analysis from the 36th month of imatinib treatment, cumulative 4-year overall survival (OS) for patients with chronic anemia was 94.4% (CI 95% 83.8-100) compared to 93.5% (CI 95% 87.2-99.8) for patients without chronic anemia (P 5 0.617). In conclusion, the occurrence of a late chronic anemia during long-lasting treatment with imatinib has been observed in about 30% of our responsive patients: its occurrence does not seem to affect OS, but its real impact should be evaluated on a larger cohort of patients. Am. J.

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Incidence of persistent/late chronic anemia in newly diagnosed patients with chronic myeloid leukemia responsive to imatinib

Latagliata

Volpicelli²,

Breccia

et al. 2014

American J Hematol

View full text Add to dashboard Cite

show abstract

“…Increase in marrow lymphocytes is definitely related to the therapy and did not correlate with Ph status [11]. Bone marrow hypoplasia has also been reported in a study in five cases [24]. Granuloma formation may be attributed one of the rare complication of Imatinib or the patient may have developed a granulomatous condition like tuberculosis [25].…”

Section: Discussionmentioning

confidence: 97%

Morphologic Changes in the Bone Marrow in Patients of Chronic Myeloid Leukemia (CML) Treated with ImatinibMesylate

Srinivas

Paul

Uppin

et al. 2012

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

Imatinib mesylate (Gleevec) is an effective treatment for chronic myeloid leukemia (CML). Though cytogenetic and molecular analyses are essential disease monitoring parameters in CML bone marrow morphological response is not well defined. We examined marrow samples from 40 patients with CML which have at least 2 or more follow-up marrow. A significant positive correlation with complete cytogenetic response shown for normalization of cellularity (P = 0.0097), absence of dry tap (P = 0.0368) and abnormal megakaryocytes (P = 0.005), reduction of blasts (P = 0.019), basophils (P = 0.031), M:E index (P = 0.018) and fibrosis (P = 0.018). Morphological criteria for complete cytogenetic response in CML patients treated with Imatinib can be defined.Morphologic response is also of potential clinical value in addition to cytogenetic and molecular response in patients of CML treated with Imatinib.

show abstract

“…Although IM has not been reported so far as a causative agent for GMT, changes in BM architecture have been associated with this treatment. These consisted mainly of a rapid decline in cellularity with various degrees of fibrosis, severe aplasia and even BM necrosis [14,15,16,17,18,19]. Several hypotheses might explain the association between IM treatment and BM stromal processes.…”

Section: Discussionmentioning

confidence: 99%

Gelatinous Transformation of Bone Marrow in Chronic Myeloid Leukemia during Treatment with Imatinib Mesylate: A Disease or a Drug Effect?

Ram¹,

Gafter‐Gvili²,

Okon

et al. 2008

Acta Haematol

View full text Add to dashboard Cite

Gelatinous marrow transformation (GMT) is an unusual pathological manifestation of progressive malignant diseases and severe malnutrition states. GMT has been associated with various accelerated hematological malignancies, but has never been described in patients with chronic myelogenous leukemia (CML) treated with imatinib mesylate (IM), a novel tyrosine kinase inhibitor. Herein we report 2 patients with stable chronic phase CML who developed GMT during the course of treatment with IM. A comprehensive review of the relevant published data, several possible mechanisms and therapeutic alternatives are suggested.

show abstract

Bone marrow aplasia—a rare complication of imatinib therapy in CML patients

Cited by 22 publications

References 7 publications

Incidence of persistent/late chronic anemia in newly diagnosed patients with chronic myeloid leukemia responsive to imatinib

Incidence of persistent/late chronic anemia in newly diagnosed patients with chronic myeloid leukemia responsive to imatinib

Morphologic Changes in the Bone Marrow in Patients of Chronic Myeloid Leukemia (CML) Treated with ImatinibMesylate

Gelatinous Transformation of Bone Marrow in Chronic Myeloid Leukemia during Treatment with Imatinib Mesylate: A Disease or a Drug Effect?

Contact Info

Product

Resources

About