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 Blood, 15 January 2006, Vol. 107, No. 2, pp. 480-482.
Prepublished online as a Blood First Edition Paper on September 29, 2005; DOI 10.1182/blood-2005-05-1816.

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CLINICAL TRIALS AND OBSERVATIONS
Brief report

Sudden blastic transformation in patients with chronic myeloid leukemia treated with imatinib mesylate

Elias Jabbour, Hagop Kantarjian, Susan O'Brien, Mary Beth Rios, Lynne Abruzzo, Srdan Verstovsek, Guillermo Garcia-Manero, and Jorge Cortes

From the Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, TX.

Sudden blastic transformation (SBT) has been reported in 0.5% to 2.5% of patients treated with interferon-{alpha} (IFN-{alpha}) during the first 3 years of therapy. Imatinib is now standard therapy for patients with chronic myeloid leukemia in chronic phase. We investigated the occurrence of SBT among patients treated with imatinib. Among 541 patients treated with imatinib in chronic phase, 23 developed blast phase, which was of sudden onset (ie, occurring in patients previously in complete cytogenetic remission) in 4 patients (17%; 0.7% of the total), 2 lymphoid and 2 myeloid. Patients with SBT were found to have low-risk features more often at the time of presentation and had achieved optimal response with imatinib. Three of the 4 patients underwent allogeneic stem cell transplantation and achieved a molecular remission. SBT is still a rare event, probably less common than that observed with IFN-{alpha} therapy. Continuous monitoring of patients treated with imatinib is mandatory.


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