Imatinib front-line therapy is safe and effective in patients with chronic myelogenous leukemia with pre-existing liver and/or renal dysfunction

Wei Gang Tong, Hagop Kantarjian, Susan O'Brien, Stefan Faderl, Farhad Ravandi, Gautam Borthakur, Jianqin Shan, Sherry Pierce, Mary Beth Rios, Jorge Cortes

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

BACKGROUND: Imatinib 400 mg daily is the standard treatment for patients with chronic myelogenous leukemia (CML). The safety and efficacy of imatinib in CML patients with pre-existing liver and/or renal dysfunction has not been analyzed. METHODS: The authors analyzed the outcome of 259 patients with early chronic phase CML treated with imatinib (starting dose 400 mg in 50, 800 mg in 209). Pre-existing liver and/or renal dysfunction was seen in 38 (15%) and 11 (4%) patients, respectively. RESULTS: Dose reductions were required in 91 (43%) of 210 patients with normal organ function, compared with 8 (73%) of 11 (P=.065) with renal dysfunction, and 19 (50%) of 38 (P=.271) with liver dysfunction. Grade 3-4 hematologic toxicities including anemia (29%, 10%, and 7% of patients with renal dysfunction, liver dysfunction, and normal organ function, respectively), neutropenia (57%, 30%, and 30%), and thrombocytopenia (43%, 30%, and 26%) were more frequent in patients with pre-existing renal dysfunction treated with high-dose imatinib. Grade 3-4 nonhematologic toxicities were observed at similar frequencies. Complete cytogenetic response rates, event-free survival, and overall survival were similar in all groups. CONCLUSIONS: Although patients with pre-existing liver and/or renal dysfunction might have a higher rate of hematologic toxicity and require more frequent dose reductions, most patients can be adequately managed, resulting in response rates and survival similar to those without pre-existing organ dysfunction.

Original languageEnglish (US)
Pages (from-to)3152-3159
Number of pages8
JournalCancer
Volume116
Issue number13
DOIs
StatePublished - Jul 1 2010

Keywords

  • Chronic myelogenous leukemia
  • Dose reduction
  • Imatinib
  • Liver and/or renal dysfunction
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Tong, W. G., Kantarjian, H., O'Brien, S., Faderl, S., Ravandi, F., Borthakur, G., Shan, J., Pierce, S., Rios, M. B., & Cortes, J. (2010). Imatinib front-line therapy is safe and effective in patients with chronic myelogenous leukemia with pre-existing liver and/or renal dysfunction. Cancer, 116(13), 3152-3159. https://doi.org/10.1002/cncr.25071