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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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Submitted May 4, 2005
Accepted July 7, 2005

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*

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

* Corresponding author; email: jcortes{at}mdanderson.org.

Sudden blastic transformation (SBT) has been reported in 0.5% to 2.5% of patients treated with interferon-alpha during the first three years of therapy. Imatinib (IM) is now standard therapy for patients with chronic myeloid leukemia in chronic phase. We investigated the occurrence of SBT among patients treated with IM. Among 541 patients treated with IM in chronic phase, 23 developed blast phase, which was of sudden onset (i.e., 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 more often low-risk features at the time of presentation and had achieved optimal response with IM. Three of the four 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 IM is mandatory.


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