title: Chronic myeloid leukemia within a year of kidney transplant with elevated alkaline phosphatase correlated with imatinib therapy.
abstract: The incidence of certain malignancies is significantly higher after organ transplant. However, there are rare reports of chronic myeloid leukemia in the posttransplant setting. The average reported interval between a transplant and the diagnosis of chronic myeloid leukemia is 44 months (range, 10- 96 mo). We report 2 patients with chronic myeloid leukemia within 1 year of a kidney transplant, which is significantly shorter than those previously reported. Both patients were receiving mycophenolate mofetil and tacrolimus for immunosuppression. They were treated with imatinib for chronic myeloid leukemia, and both patients demonstrated an isolated elevation of serum alkaline phosphatase that was directly correlated with imatinib. Despite a potential interaction between the 2 drugs, blood levels of tacrolimus and imatinib were not elevated during the course of treatment. Isolated elevation of alkaline phosphatase in this particular setting has not been reported previously.
authors.affiliation: Indiana University Simon Cancer Center, Indiana University School of Medicine, Department of Medicine, Division of Hematology-Oncology, Indianapolis, IN, USA. ssayar@iupui.edu
authors.forename: Hamid
authors.initials: H
authors.lastname: Sayar
authors.forename: Asif A
authors.initials: AA
authors.lastname: Sharfuddin
authors.forename: Tim E
authors.initials: TE
authors.lastname: Taber
authors.forename: Rakesh
authors.initials: R
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001549:Benzamides; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D006801:Humans; D000068877:Imatinib Mesylate; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D010879:Piperazines / Q000009:adverse effects*; D011743:Pyrimidines / Q000009:adverse effects*; D016559:Tacrolimus / Q000009:adverse effects; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D015415:Biomarkers; D007166:Immunosuppressive Agents; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D000469:Alkaline Phosphatase; D009173:Mycophenolic Acid; D016559:Tacrolimus