Severe bone marrow aplasia following imatinib mesylate in a patient with chronic myelogenous leukemia

Lokeshwar, Nilesh; Kumar, Lalit; Kumari, Mamta

doi:10.1080/10428190500046778

Cited by 24 publications

(16 citation statements)

References 9 publications

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“…Marrow hypoplasia following imatinib therapy has infrequently been reported [7][8][9].Bone marrow hypoplasia is a potentially fatal adverse side-effect of imatinib and can present in any phase of CML. In one of the studies [9], there were five patients with severe hypoplasia (bone marrow cellularity between 5 and 10%) the Bcr/Abl was positive in all patients at the time of hypoplasia.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Cytopenias Occurring in Imatinib Treated Chronic Myeloid Leukemia (CML) Patients

Paul

Uppin

et al. 2010

Indian J Hematol Blood Transfus

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Imatinib Mesylate, a Tyrosine Kinase inhibitor, is presently the drug of choice for Chronic myeloid leukemia (CML). During therapy, a few patients develop myelosuppression and present with cytopenias. To study the bone marrow morphology in imatinib treated CML patients presenting with persistent cytopenias. The cases were retrieved from the Hematopathology record files, Department of Pathology; the study period being January 2008-June 2009. Cases of CML on Imatinib presenting with grade 2 or more anemia, neutropenia and/or thrombocytopenias with bone marrow studies, were included in the study. The morphology of all cases was reviewed with cytogenetic studies. Follow-up details were obtained from the Medical Oncology records. During the study period, 683 Imatinib treated CML patients had bone marrow studies as part of their follow-up investigations. Of these, 60 patients (9%) had some form of persistent cytopenia. The patients ranged from 21 to 75 years of age with a median age of 38 years. The male:female ratio was 1:1. There were 46 patients with ≥grade 2 anemia, 25 patients with ≥grade 2 neutropenia and 37 patients with ≥grade 2 thrombocytopenia. Of these, 18 patients had bicytopenia and 13 cases had pancytopenia. The marrow evaluation revealed morphologic response in 30 patients, persistent marrow disease in five patients, marrow hypoplasia in six patients, extensive stromal changes including fibrosis in five patients, megaloblastic erythropoiesis in 11 patients and disease progression to accelerated or blast crisis in three patients. Various degrees of cytopenias may occur in few patients of CML on imatinib therapy. Regular hematologic follow-up is required so that the drug may be stopped or dose modified as per the individual's needs.

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Section: Discussionmentioning

confidence: 98%

Evaluation of Cytopenias Occurring in Imatinib Treated Chronic Myeloid Leukemia (CML) Patients

Paul

Uppin

et al. 2010

Indian J Hematol Blood Transfus

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“…To the best of our knowledge, only three case reports of bone marrow aplasia has been reported in the literature till date. Lokeshwar et al reported a case of severe bone marrow aplasia following 6 weeks of imatinib mesylate therapy and the patient died of pulmonary mucormycosis [7]. Chng and Tan also reported a case in which bone marrow aplasia occurred after prolonged period of imatinib therapy [8].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2007

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Imatinib mesylate therapy in CML patients is a generally well tolerated without any significant hematological adverse drug effects. However, complications like anemia and cytopenias have been described in literature. A very few case reports of bone marrow aplasia following imatinib therapy have been reported so far. We here report five patients of CML who developed bone marrow aplasia following imatinib therapy. Am. J. Hematol. 82:314-316, 2007. V V C 2006 Wiley-Liss, Inc.

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“…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

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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.

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Severe bone marrow aplasia following imatinib mesylate in a patient with chronic myelogenous leukemia

Cited by 24 publications

References 9 publications

Evaluation of Cytopenias Occurring in Imatinib Treated Chronic Myeloid Leukemia (CML) Patients

Evaluation of Cytopenias Occurring in Imatinib Treated Chronic Myeloid Leukemia (CML) Patients

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

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

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