Document Detail


Imatinib front-line therapy is safe and effective in patients with chronic myelogenous leukemia with pre-existing liver and/or renal dysfunction.
MedLine Citation:
PMID:  20564631     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Wei-Gang Tong; Hagop Kantarjian; Susan O'Brien; Stefan Faderl; Farhad Ravandi; Gautam Borthakur; Jianqin Shan; Sherry Pierce; Mary Beth Rios; Jorge Cortes
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer     Volume:  116     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3152-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antineoplastic Agents / adverse effects,  therapeutic use*
Female
Humans
Kidney Diseases / complications*,  physiopathology
Leukemia, Myeloid, Chronic-Phase / complications*,  drug therapy*,  mortality
Liver Diseases / complications*,  physiopathology
Male
Middle Aged
Piperazines / administration & dosage,  adverse effects,  therapeutic use*
Protein Kinase Inhibitors / adverse effects,  therapeutic use*
Pyrimidines / administration & dosage,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Piperazines; 0/Protein Kinase Inhibitors; 0/Pyrimidines; 152459-95-5/imatinib

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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