Development of hypogammaglobulinemia in patients treated with imatinib for chronic myeloid leukemia or gastrointestinal stromal tumor.
Imatinib mesylate is a tyrosine kinase inhibitor used as first line treatment in chronic myeloid leukemia and gastrointestinal stromal tumor patients. Although several in vitro and animal studies demonstrated that imatinib affects immune response, few immune alterations are described in humans. We retrospectively studied hematologic and immunological parameters in 72 chronic myeloid leukemia and 15 gastrointestinal stromal tumor patients treated with imatinib at standard dosage and in 20 chronic myeloid leukemia patients treated before the introduction of imatinib in clinical practice. Both chronic myeloid leukemia and gastrointestinal stromal tumor patients developed a significant reduction of gammaglobulin and immunoglobulin serum levels. No significant hypogammaglobulinemia was observed in chronic myeloid leukemia patients in the pre-imatinib era. These data demonstrate that imatinib treatment induces hypogammaglobulinemia that can reach a severe entity in 10% of cases, both in chronic myeloid leukemia and in gastrointestinal stromal tumor patients. Prospective studies are needed to evaluate immune humoral alterations and to define the real incidence of infectious events, including viral reactivations.
Department of Oncology and Haematology, Hematology Division, University of Modena and Reggio Emilia, Modena, Italy.
Rita
R
Santachiara
Rossana
R
Maffei
Silvia
S
Martinelli
Annalisa
A
Arcari
Federico
F
Piacentini
Elena
E
Trabacchi
Pierluigi
P
Alfieri
Angela
A
Ferrari
Giovanna
G
Leonardi
Gabriele
G
Luppi
Giuseppe
G
Longo
Daniele
D
Vallisa
Roberto
R
Marasca
Giuseppe
G
Torelli
D000328:Adult; D000361:Agammaglobulinemia / Q000139:chemically induced*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001549:Benzamides; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D007136:Immunoglobulins / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use*; D012189:Retrospective Studies; D005719:gamma-Globulins / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001549:Benzamides; D007136:Immunoglobulins; D010879:Piperazines; D011743:Pyrimidines; D005719:gamma-Globulins; D000068877:Imatinib Mesylate