Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase

ABSTRACT Introduction: The incidence of grade 3-4 anemia was reported to be 3% with imatinib therapy for newly diagnosed chronic myeloid leukemia (CML) in the chronic phase (CP). However, there are few data regarding the causes and the development of anemia after long-term treatment. This study aimed to evaluate the incidence of anemia after at least two years of imatinib treatment of CML patients in the CP and to identify other contributing causes of anemia in this population. Patients and methods: We performed a retrospective analysis of 97 CML patients in the CP treated with imatinib for at least two years. We analyzed the hemoglobin (Hb) levels of CML patients at diagnosis, upon initiation of treatment with imatinib and after two years of imatinib treatment, and investigated other causes of anemia in this population. Results: Most of the patients presented Hb levels below the normal range (80.4%) after the second year of treatment, 17.9% grade 2 and 1.3% grade 3. In 13 cases (16.7%), anemia was attributed to resistance and in 13 cases (16.7%) the following causes were identified: iron deficiency (n = 5), hypothyroidism (n = 2), vitamin B12 deficiency (n = 3), acquired immune deficiency syndrome (AIDS) (n = 1), pulmonary tuberculosis (n = 1) and renal toxicity (n = 1). In 52 patients (66.6%), there were no other factors contributing to anemia, except imatinib treatment. Conclusion: Regular follow-up is required to identify the causes of anemia not related to CML or imatinib toxicity. The importance of investigating secondary causes of anemia should be emphasized, especially in patients with good adherence to treatment and satisfactory therapeutic response.

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Main Authors: Moura,Muriel Silva, Benevides,Thais Celi Lopes, Delamain,Marcia Torresan, Duarte,Gislaine Oliveira, Percout,Priscila Oliveira, Dias,Maria Almeida, Zulli,Roberto, Souza,Carmino Antonio de, Lorand-Metze,Irene, Pagnano,Katia Borgia Barbosa
Format: Digital revista
Language:English
Published: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) 2019
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2531-13792019000400329
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spelling oai:scielo:S2531-137920190004003292019-11-22Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phaseMoura,Muriel SilvaBenevides,Thais Celi LopesDelamain,Marcia TorresanDuarte,Gislaine OliveiraPercout,Priscila OliveiraDias,Maria AlmeidaZulli,RobertoSouza,Carmino Antonio deLorand-Metze,IrenePagnano,Katia Borgia Barbosa Chronic myeloid leukemia Imatinib Anemia Adverse events ABSTRACT Introduction: The incidence of grade 3-4 anemia was reported to be 3% with imatinib therapy for newly diagnosed chronic myeloid leukemia (CML) in the chronic phase (CP). However, there are few data regarding the causes and the development of anemia after long-term treatment. This study aimed to evaluate the incidence of anemia after at least two years of imatinib treatment of CML patients in the CP and to identify other contributing causes of anemia in this population. Patients and methods: We performed a retrospective analysis of 97 CML patients in the CP treated with imatinib for at least two years. We analyzed the hemoglobin (Hb) levels of CML patients at diagnosis, upon initiation of treatment with imatinib and after two years of imatinib treatment, and investigated other causes of anemia in this population. Results: Most of the patients presented Hb levels below the normal range (80.4%) after the second year of treatment, 17.9% grade 2 and 1.3% grade 3. In 13 cases (16.7%), anemia was attributed to resistance and in 13 cases (16.7%) the following causes were identified: iron deficiency (n = 5), hypothyroidism (n = 2), vitamin B12 deficiency (n = 3), acquired immune deficiency syndrome (AIDS) (n = 1), pulmonary tuberculosis (n = 1) and renal toxicity (n = 1). In 52 patients (66.6%), there were no other factors contributing to anemia, except imatinib treatment. Conclusion: Regular follow-up is required to identify the causes of anemia not related to CML or imatinib toxicity. The importance of investigating secondary causes of anemia should be emphasized, especially in patients with good adherence to treatment and satisfactory therapeutic response.info:eu-repo/semantics/openAccessAssociação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH)Hematology, Transfusion and Cell Therapy v.41 n.4 20192019-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2531-13792019000400329en10.1016/j.htct.2019.03.006
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libraryname SciELO
language English
format Digital
author Moura,Muriel Silva
Benevides,Thais Celi Lopes
Delamain,Marcia Torresan
Duarte,Gislaine Oliveira
Percout,Priscila Oliveira
Dias,Maria Almeida
Zulli,Roberto
Souza,Carmino Antonio de
Lorand-Metze,Irene
Pagnano,Katia Borgia Barbosa
spellingShingle Moura,Muriel Silva
Benevides,Thais Celi Lopes
Delamain,Marcia Torresan
Duarte,Gislaine Oliveira
Percout,Priscila Oliveira
Dias,Maria Almeida
Zulli,Roberto
Souza,Carmino Antonio de
Lorand-Metze,Irene
Pagnano,Katia Borgia Barbosa
Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
author_facet Moura,Muriel Silva
Benevides,Thais Celi Lopes
Delamain,Marcia Torresan
Duarte,Gislaine Oliveira
Percout,Priscila Oliveira
Dias,Maria Almeida
Zulli,Roberto
Souza,Carmino Antonio de
Lorand-Metze,Irene
Pagnano,Katia Borgia Barbosa
author_sort Moura,Muriel Silva
title Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
title_short Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
title_full Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
title_fullStr Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
title_full_unstemmed Evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
title_sort evaluation of anemia after long-term treatment with imatinib in chronic myeloid leukemia patients in chronic phase
description ABSTRACT Introduction: The incidence of grade 3-4 anemia was reported to be 3% with imatinib therapy for newly diagnosed chronic myeloid leukemia (CML) in the chronic phase (CP). However, there are few data regarding the causes and the development of anemia after long-term treatment. This study aimed to evaluate the incidence of anemia after at least two years of imatinib treatment of CML patients in the CP and to identify other contributing causes of anemia in this population. Patients and methods: We performed a retrospective analysis of 97 CML patients in the CP treated with imatinib for at least two years. We analyzed the hemoglobin (Hb) levels of CML patients at diagnosis, upon initiation of treatment with imatinib and after two years of imatinib treatment, and investigated other causes of anemia in this population. Results: Most of the patients presented Hb levels below the normal range (80.4%) after the second year of treatment, 17.9% grade 2 and 1.3% grade 3. In 13 cases (16.7%), anemia was attributed to resistance and in 13 cases (16.7%) the following causes were identified: iron deficiency (n = 5), hypothyroidism (n = 2), vitamin B12 deficiency (n = 3), acquired immune deficiency syndrome (AIDS) (n = 1), pulmonary tuberculosis (n = 1) and renal toxicity (n = 1). In 52 patients (66.6%), there were no other factors contributing to anemia, except imatinib treatment. Conclusion: Regular follow-up is required to identify the causes of anemia not related to CML or imatinib toxicity. The importance of investigating secondary causes of anemia should be emphasized, especially in patients with good adherence to treatment and satisfactory therapeutic response.
publisher Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH)
publishDate 2019
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2531-13792019000400329
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