title: Incidence of persistent/late chronic anemia in newly diagnosed patients with chronic myeloid leukemia responsive to imatinib.
abstract: In patients with chronic myeloid leukemia (CML) responsive to imatinib, it is still unknown whether the long-lasting treatment could induce the appearance of a persistent/late chronic anemia. To highlight this issue, we revised 128 patients with CML (M/F 64/64, median age at diagnosis 56.9 years, interquartile range 43.0-69.3) treated at our Institution with 1st line imatinib for at least 36 months and in stable complete cytogenetic response. At the 36th month of imatinib, a chronic anemia (Hb < 12 g/dl for > 6 months) was present in 38/128 patients (29.6%): the anemia was moderate (Hb > 8 ≤ 10 g/dl) in 12 patients (9.3%) and mild (Hb > 10 < 12 g/dl) in 26 patients (20.3%). All patients with persistent/late chronic anemia had a low reticulocyte count and 8/38 a condition of iron deficiency without clinical and instrumental signs of chronic blood loss. Four out of 38 patients (10.5%) needed red cell transfusions during the follow-up. At a landmark analysis from the 36th month of imatinib treatment, cumulative 4-year overall survival (OS) for patients with chronic anemia was 94.4% (CI 95% 83.8-100) compared to 93.5% (CI 95% 87.2-99.8) for patients without chronic anemia (P = 0.617). In conclusion, the occurrence of a late chronic anemia during long-lasting treatment with imatinib has been observed in about 30% of our responsive patients: its occurrence does not seem to affect OS, but its real impact should be evaluated on a larger cohort of patients.
authors.affiliation: Department of Cellular Biotechnologies and Hematology, University "La Sapienza" of Rome, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
authors.forename: Paola
authors.initials: P
authors.lastname: Volpicelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Federico
authors.initials: F
authors.lastname: Vozella
authors.forename: Angela
authors.initials: A
authors.lastname: Romano
authors.forename: Chiara
authors.initials: C
authors.lastname: Montagna
authors.forename: Matteo
authors.initials: M
authors.lastname: Molica
authors.forename: Paola
authors.initials: P
authors.lastname: Finsinger
authors.forename: Ida
authors.initials: I
authors.lastname: Carmosino
authors.forename: Alessandra
authors.initials: A
authors.lastname: Serrao
authors.forename: Irene
authors.initials: I
authors.lastname: Zacheo
authors.forename: Michelina
authors.initials: M
authors.lastname: Santopietro
authors.forename: Adriano
authors.initials: A
authors.lastname: Salaroli
authors.forename: Giuliana
authors.initials: G
authors.lastname: Alimena
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D012156:Reticulocytes / Q000473:pathology; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate