ABSTRACT
Introduction: The
incidence of grade 3-4
anemia was reported to be 3% with
imatinib therapy for newly diagnosed
chronic myeloid leukemia (CML) in the chronic phase (CP). However, there are few data regarding the causes and the development of
anemia after long-term
treatment . This study aimed to evaluate the
incidence of
anemia after at least two years of
imatinib treatment of CML
patients in the CP and to identify other contributing causes of
anemia in this
population .
Patients and
methods: We performed a retrospective
analysis of 97 CML
patients in the CP treated with
imatinib for at least two years. We analyzed the
hemoglobin (Hb) levels of CML
patients at
diagnosis , upon initiation of
treatment with
imatinib and after two years of
imatinib treatment , and investigated other causes of
anemia in this
population .
Results: Most of the
patients presented Hb levels below the
normal range (80.4%) after the second year of
treatment , 17.9% grade 2 and 1.3% grade 3. In 13 cases (16.7%),
anemia was attributed to resistance and in 13 cases (16.7%) the following causes were identified
iron deficiency (n = 5),
hypothyroidism (n = 2),
vitamin B12 deficiency (n = 3),
acquired immune deficiency syndrome (
AIDS ) (n = 1),
pulmonary tuberculosis (n = 1) and renal
toxicity (n = 1). In 52
patients (66.6%), there were no other factors contributing to
anemia , except
imatinib treatment .
Conclusion: Regular follow-up is required to identify the causes of
anemia not related to CML or
imatinib toxicity . The importance of investigating
secondary causes of
anemia should be emphasized, especially in
patients with good adherence to
treatment and satisfactory
therapeutic response.