Published online 2 June 2008
Haematologica, Vol 93, Issue 8, 1252-1255 doi:10.3324/haematol.12642
Copyright © 2008 by Ferrata Storti Foundation
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Chronic Myeloid Leukemia

Development of hypogammaglobulinemia in patients treated with imatinib for chronic myeloid leukemia or gastrointestinal stromal tumor

Rita Santachiara1, Rossana Maffei1, Silvia Martinelli1, Annalisa Arcari2, Federico Piacentini3, Elena Trabacchi2, Pierluigi Alfieri1, Angela Ferrari1, Giovanna Leonardi1, Gabriele Luppi3, Giuseppe Longo3, Daniele Vallisa2, Roberto Marasca1, Giuseppe Torelli1

1 Department of Oncology and Haematology, Hematology Division, University of Modena and Reggio Emilia, Modena
2 Department of Oncology and Haematology, Haematology Division, Civil Hospital of Piacenza, Piacenza
3 Department of Oncology and Haematology, Oncology Division, University of Modena and Reggio Emilia, Modena, Italy

Correspondence: Roberto Marasca, MD, Hematology Division, Policlinico, via del Pozzo 71, 41100 Modena, Italy. E-mail:roberto.marasca{at}unimore.it

Imatinib mesylate is a tyrosine kinase inhibitor used as first line treatment in chronic myeloid leukemia and gastrointestinal stromal tumorpatients. Although several in vitro and animal studies demonstrated that imatinib affects immune response, few immune alterations are described in humans. We retrospectively studied hematologic and immunological parameters in 72 chronic myeloid leukemia and 15 gastrointestinal stromal tumor patients treated with imatinib at standard dosage and in 20 chronic myeloid leukemia patients treated before the introduction of imatinib in clinical practice. Both chronic myeloid leukemia and gastrointestinal stromal tumor patients developed a significant reduction of gammaglobulin and immunoglobulin serum levels. No significant hypogammaglobulinemia was observed in chronic myeloid leukemia patients in the pre-imatinib era. These data demonstrate that imatinib treatment induces hypogammaglobulinemia that can reach a severe entity in 10% of cases, both in chronic myeloid leukemia and in gastrointestinal stromal tumor patients. Prospective studies are needed to evaluate immune humoral alterations and to define the real incidence of infectious events, including viral reactivations.

Key words: chronic myeloid leukemia, imatinib, hypogammaglobulinemia.