Which factors affect the safety and effectiveness of imatinib treatment for newly diagnosed chronic myeloid leukemia?

This study aimed to investigate the safety and effectiveness of imatinib treatment in patients with newly diagnosed chronic myeloid leukemia. This study concluded that patients of lower weight and older age are more vulnerable to side effects. 

Imatinib (Gleevec) is a targeted therapy used to treat chronic myeloid leukemia (CML). There are dose-limiting toxicities (DLTs) associated with imatinib use. DLTs are side effects that limit the dosage of treatment.  

It was not known if a fixed dose of imatinib treatment was safe and effective in patients with newly diagnosed CML and which factors would cause DLTs. 

This study involved data from 1003 patients with newly diagnosed CML. All patients were treated with a fixed dose of 400 mg imatinib every day. 

After 12 months, 45.4% of patients experienced at least one type of DLT. 40% of patients experienced thrombocytopenia (low platelet count). 14.3% of patients experienced neutropenia or leukopenia (low level of white blood cells). 12.1% experienced skin reactions.  

57.9% of patients weighing under 64 kg and aged over 43 years experienced a DLT by 12 months. This was compared to 30.1% of patients who were heavier than 64 kg and aged 43 or younger.  

38.9% of patients achieved a major molecular response (MMR) at 12 months. MMR is when there is a very low level of cancer genes present in cells. 45.6% of female patients achieved MMR compared to 35.5% of male patients. 

This study concluded that patients who weighed less and were older are more vulnerable to DLTs from imatinib treatment. The authors suggested that the imatinib dose should be reduced to 300 mg or lower in patients experiencing DLTs.

This study was based on medical records. Some data was missing. This might have affected the results. Further studies are needed for stronger evidence.