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Renal dysfunction and anemia associated with long-term imatinib treatment in patients with chronic myelogenous leukemia

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Abstract

Knowledge of the toxicity profile of long-term treatment with imatinib is limited. In the present study, we sought to evaluate renal function and hemoglobin levels during long-term imatinib treatment. Eighty-two patients with chronic myelogenous leukemia in chronic phase who had been on imatinib for over 5 years were retrospectively analyzed. The mean estimated glomerular filtration rate (eGFR) was significantly decreased over 5 years (77 ± 17 to 62 ± 14 ml/min/1.73m², P < 0.001). Higher age and lower eGFR value at initiation of imatinib were significantly associated with development of renal dysfunction by multivariate analyses. Mean hemoglobin levels also significantly decreased over the 5-year period (12.9 ± 1.7 to 12.4 ± 1.3 g/dl, P < 0.01). The rate of decrease in eGFR correlated significantly with hemoglobin levels (correlation coefficient = − 0.249, P < 0.05). Serum erythropoietin (EPO) levels did not increase in 16 patients with both renal dysfunction and anemia (median, 31.9 mIU/ml). In patients who participated in a clinical trial of imatinib discontinuation, mean eGFR (50.0 ± 6.5 to 56.0 ± 10.2 ml/min/1.73m², P < 0.05) and hemoglobin levels (12.0 ± 1.7 to 14.0 ± 1.6 g/dl, P < 0.01) improved significantly at 1 year after discontinuation. These findings suggest that long-term imatinib results in a partially reversible continuous decline in renal function and decreased hemoglobin levels.

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Masatoshi Sakurai, Taku Kikuchi, Daiki Karigane, Hidenori Kasahara, Eri Matsuki, Risa Hashida, Yusuke Yamane, Ryohei Abe, Yuya Koda, Takaaki Toyama, Jun Kato, Takayuki Shimizu, Shinichiro Okamoto & Takehiko Mori

  2. Division of Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy, Tokyo, Japan

    Yuta Yokoyama, Sayo Suzuki & Tomonori Nakamura

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  1. Masatoshi Sakurai
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  2. Taku Kikuchi
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Correspondence to Takehiko Mori.

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SO and TM received research funding and honoraria for lectures from Bristol-Myers Squibb and Novartis Pharmaceuticals.

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Sakurai, M., Kikuchi, T., Karigane, D. et al. Renal dysfunction and anemia associated with long-term imatinib treatment in patients with chronic myelogenous leukemia. Int J Hematol 109, 292–298 (2019). https://doi.org/10.1007/s12185-019-02596-z

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  • DOI: https://doi.org/10.1007/s12185-019-02596-z

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