Marrow signal changes observed in follow-up whole-body MRI studies in children and young adults with neurofibromatosis type 1 treated with imatinib mesylate (Gleevec) for plexiform neurofibromas.
BACKGROUND
We observed bone marrow signal changes (BMSC) in patients with plexiform neurofibromas after treatment with imatinib mesylate (Gleevec).


OBJECTIVE
To evaluate the pattern and natural history of BMSC.


METHODS
The data were obtained from a pilot study of imatinib mesylate in patients with plexiform neurofibromas. All patients underwent baseline and sequential whole-body STIR 1.5-T MRI after treatment. The bone marrow signal on MRI was evaluated for abnormalities, location and pattern, and any change on follow-up studies.


RESULTS
The study group included 16 patients (8 males) with a median age of 14 years (range 4 to 25 years). The mean whole-body MRI follow-up duration was 1.9 years. Of the 16 patients, 14 (88%) developed BMSC. The signal change was asymmetrical in 9 of the 14 patients (64%). The appendicular skeleton was involved in all 14 patients and the axial skeleton in 3 patients (21%). BMSC was followed in 13 patients and decreased signal was seen in 9 patients (69%) after a mean duration of 1.3 years of treatment (range 0.6 to 2.9 years); no complications were observed.


CONCLUSIONS
BMSC appeared in most patients with neurofibromatosis type 1 following treatment with imatinib mesylate. BMSC was unusually asymmetrical and involved the lower extremities. On follow-up, BMSC often showed a decrease without complications.
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, Indiana University Health, 705 Riley Hospital Drive, Rm. 1053, Indianapolis, IN 46260, USA. bkarmazy@iupui.edu
Boaz
B
Karmazyn
Mervyn D
MD
Cohen
Samuel Gregory
SG
Jennings
Kent A
KA
Robertson
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D008297:Male; D018318:Neurofibroma, Plexiform / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D009456:Neurofibromatosis 1 / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D010865:Pilot Projects; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods; D055815:Young Adult
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate