Congestive heart failure is a rare event in patients receiving imatinib therapy

Atallah, Ehab; Durand, Jean-Bernard; Kantarjian, Hagop M.; Cortes, Jorge

doi:10.1182/blood-2007-01-070144

Cited by 227 publications

(125 citation statements)

References 32 publications

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“…19 Two recent publications have addressed this concern in large numbers of patients. 23,24 The first report by Atallah et al 24 reviewed the records of 1276 patients who received imatinib on clinical trails at the MD Anderson Cancer Center. In total, 22 (1.7%) of these patients were identified as having symptoms that could be related to CHF, although only 8 (0.6%) of these were considered possibly or probably related to imatinib.…”

Section: Iris 6-year Follow-upmentioning

confidence: 99%

Six-year follow-up of patients receiving imatinib for the first-line treatment of chronic myeloid leukemia

et al. 2009

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Imatinib mesylate is considered standard of care for firstline treatment of chronic phase chronic myeloid leukemia (CML-CP). In the phase III, randomized, open-label International Randomized Study of Interferon vs STI571 (IRIS) trial, previously untreated CML-CP patients were randomized to imatinib (n ¼ 553) or interferon-a (IFN) plus cytarabine (n ¼ 553). This 6-year update focuses on patients randomized to receive imatinib as first-line therapy for newly diagnosed CML-CP. During the sixth year of study treatment, there were no reports of disease progression to accelerated phase (AP) or blast crisis (BC). The toxicity profile was unchanged. The cumulative best complete cytogenetic response (CCyR) rate was 82%; 63% of all patients randomized to receive imatinib and still on study treatment showed CCyR at last assessment. The estimated event-free survival at 6 years was 83%, and the estimated rate of freedom from progression to AP and BC was 93%. The estimated overall survival was 88%--or 95% when only CMLrelated deaths were considered. This 6-year update of IRIS underscores the efficacy and safety of imatinib as first-line therapy for patients with CML.

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Section: Iris 6-year Follow-upmentioning

confidence: 99%

Six-year follow-up of patients receiving imatinib for the first-line treatment of chronic myeloid leukemia

et al. 2009

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“…[11][12][13] In each of these reports, cardiac failure and left ventricular dysfunction, which was possibly or probably related to imatinib therapy, were either not identified 11 or were found to occur rarely (0.04%/year) as in the International Randomized Study of Interferon and ST1571 trial. 12 Atallah et al 13 recently reviewed over 1200 CML patients treated with imatinib and reported the presence of CHF in 22 of the 1276 (1.7%) patients. These 22 patients had a median age of 68 (range; 50-83) years with eighteen (82%) having an earlier diagnosed cardiovascular illness leaving the authors to conclude that although the potential of cardiac related toxicity does exist while on imatinib, it is a rare event mainly seen in elderly patients with a pre-existing cardiac condition.…”

Section: Discussionmentioning

confidence: 99%

Imatinib use either pre- or post-allogeneic hematopoietic cell transplantation (allo-HCT) does not increase cardiac toxicity in chronic myelogenous leukemia patients

Burke

Trotz

Luo

et al. 2009

Bone Marrow Transplant

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Since the introduction of imatinib mesylate, the role of allogeneic hematopoietic cell transplantation (allo-HCT) for CML has essentially been reserved for patients with advanced disease or imatinib resistance. In addition, there have been concerns regarding imatinib associated cardiac toxicity. We investigated the outcome of 61 patients with CML who received a myeloablative allo-HCT at the University of Minnesota between 1999 and 2006. The median age at HCT was 38.4 (range; 6.9-56.9) years. Thirty-seven patients were in first chronic phase and twenty-four patients in a second chronic or accelerated phase at the time of HCT. Twenty-six patients received imatinib therapy before or after HCT, and thirty-five patients either never received imatinib (n ¼ 32) or received it only at the time of relapse after HCT (n ¼ 3). OS and relapse-free survival (RFS) at 2 years was 69 and 55% for the imatinib group, and 57 and 49% for the non-imatinib group (P ¼ 0.57 and 0.95, respectively). There was no difference in the risk of relapse at 2 years between the groups. Symptomatic cardiac toxicity at 1 year was reported in three imatinib group (12%) and two nonimatinib group (6%) patients (P ¼ 0.44). Thus, patients treated with imatinib either before or after myeloablative allo-HCT had no increase in cardiac toxicity.

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“…CHF was present in 22 of 1276 (1.7%) patients, with 18 of these 22 patients (82%) having a previously diagnosed cardiovascular illness. 30 The authors concluded that although the potential of cardiac-related toxicity does exist while on imatinib, it is a rare event and mainly seen in elderly patients with a preexisting cardiac condition.…”

Section: Discussionmentioning

confidence: 99%

Allo-hematopoietic cell transplantation for Ph chromosome-positive ALL: impact of imatinib on relapse and survival

Burke

Trotz

Luo

et al. 2008

Bone Marrow Transplant

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The utility of imatinib in either the pre-or post-transplant period for Ph chromosome-positive (Ph þ ) ALL is uncertain. In addition, there have been recent concerns regarding imatinib and cardiac toxicity. We investigated the outcome of 32 patients with Ph þ ALL who received an allo-hematopoietic cell transplant (HCT) at the University of Minnesota between 1999 and 2006. The median age at HCT was 21.9 years (range: 2.8-55.2). All patients were conditioned with CY and TBI. GVHD prophylaxis was CsA based. Of the 32 patients, 15 received imatinib therapy pre-or post-HCT (imatinib group) and 17 patients received either no imatinib (n ¼ 11) or only after relapse (n ¼ 6) (non-imatinib group). Overall survival, relapse-free survival and relapse at 2 years was 61, 67 and 13% for the imatinib group as compared with 41, 35 and 35% for the non-imatinib group (P ¼ 0.19, 0.12 and 0.20, respectively). Cardiac toxicity and TRM at 2 years were similar between groups. Thus, patients treated with imatinib in either the pre-or post-transplant setting had trends toward improved outcomes and no increase in cardiac toxicity. We suggest that imatinib be included in the peri-transplant management of all patients with Ph þ ALL.

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Congestive heart failure is a rare event in patients receiving imatinib therapy

Cited by 227 publications

References 32 publications

Six-year follow-up of patients receiving imatinib for the first-line treatment of chronic myeloid leukemia

Six-year follow-up of patients receiving imatinib for the first-line treatment of chronic myeloid leukemia

Imatinib use either pre- or post-allogeneic hematopoietic cell transplantation (allo-HCT) does not increase cardiac toxicity in chronic myelogenous leukemia patients

Allo-hematopoietic cell transplantation for Ph chromosome-positive ALL: impact of imatinib on relapse and survival

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