Renal dysfunction and anemia associated with long-term imatinib treatment in patients with chronic myelogenous leukemia

Masatoshi Sakurai, Taku Kikuchi, Daiki Karigane, Hidenori Kasahara, Eri Matsuki, Risa Hashida, Yusuke Yamane, Ryohei Abe, Yuya Koda, Takaaki Toyama, Jun Kato, Takayuki Shimizu, Yuta Yokoyama, Sayo Suzuki, Tomonori Nakamura, Shinichiro Okamoto, Takehiko Mori

Research output: Contribution to journalArticle

Abstract

Knowledge of the toxicity profile of long-term treatment with imatinib is limited. In the present study, we sought to evaluate renal function and hemoglobin levels during long-term imatinib treatment. Eighty-two patients with chronic myelogenous leukemia in chronic phase who had been on imatinib for over 5 years were retrospectively analyzed. The mean estimated glomerular filtration rate (eGFR) was significantly decreased over 5 years (77 ± 17 to 62 ± 14 ml/min/1.73m², P < 0.001). Higher age and lower eGFR value at initiation of imatinib were significantly associated with development of renal dysfunction by multivariate analyses. Mean hemoglobin levels also significantly decreased over the 5-year period (12.9 ± 1.7 to 12.4 ± 1.3 g/dl, P < 0.01). The rate of decrease in eGFR correlated significantly with hemoglobin levels (correlation coefficient = − 0.249, P < 0.05). Serum erythropoietin (EPO) levels did not increase in 16 patients with both renal dysfunction and anemia (median, 31.9 mIU/ml). In patients who participated in a clinical trial of imatinib discontinuation, mean eGFR (50.0 ± 6.5 to 56.0 ± 10.2 ml/min/1.73m², P < 0.05) and hemoglobin levels (12.0 ± 1.7 to 14.0 ± 1.6 g/dl, P < 0.01) improved significantly at 1 year after discontinuation. These findings suggest that long-term imatinib results in a partially reversible continuous decline in renal function and decreased hemoglobin levels.

Original languageEnglish
Pages (from-to)292-298
Number of pages7
JournalInternational journal of hematology
Volume109
Issue number3
DOIs
Publication statusPublished - 2019 Mar 20

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Keywords

  • Anemia
  • Chronic myelogenous leukemia
  • Imatinib
  • Renal dysfunction

ASJC Scopus subject areas

  • Hematology

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