Submitted April 19, 2006
Accepted June 3, 2006
Myelodysplastic syndromes and acute leukemia developing
after imatinib mesylate therapy for chronic myeloid leukemia
Craig Kovitz, Hagop Kantarjian, Guillermo Garcia-Manero, Lynne V Abruzzo, and Jorge Cortes*
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
* Corresponding author; email: jcortes{at}mdanderson.org.
During therapy with imatinib, some patients with chronic myeloid leukemia (CML) develop chromosomal abnormalities in Ph-negative cells. These are frequently transient and their clinical consequence is unclear. Although some reports have suggested these abnormalities might be associated with secondary myelodysplastic syndrome (MDS), the diagnosis has not always been established using standard criteria. We report 3 cases of patients treated with imatinib for CML who were subsequently found to have chromosomal abnormalities in Ph-negative cells. One of them developed acute myelogenous leukemia (AML) and the other two developed high risk MDS which rapidly transformed to AML. These cases were identified in a total study group of 1701 patients. Although rare, these findings highlight the need for close monitoring of patients with CML treated with imatinib.
