4th Palermo Conference on INNOVATIVE THERAPIES FOR LYMPHOID MALIGNANCIES
Published online 16 July 2009
Haematologica, Vol 94, Issue 12, 1758-1761 doi:10.3324/haematol.2009.010496
Copyright © 2009 by Ferrata Storti Foundation
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Chronic Myeloid Leukemia

Pancreatic enzyme elevation in chronic myeloid leukemia patients treated with nilotinib after imatinib failure

Francesca Palandri, Fausto Castagnetti, Simona Soverini, Angela Poerio, Gabriele Gugliotta, Simona Luatti, Marilina Amabile, Giovanni Martinelli, Gianantonio Rosti, Michele Baccarani

Department of Hematology and Oncology "L. and A. Seràgnoli", St. Orsola-Malpighi Hospital, University of Bologna, Italy

Correspondence: Francesca Palandri, MD, Department of Hematology and Medical Oncology "L. and A. Seràgnoli", St. Orsola-Malpighi University Hospital, Via Massarenti, 9, 40138 Bologna, Italy. E-mail: francesca.palandri{at}libero.it

An increase in the serum concentration of pancreatic enzymes (amylase and lipase) was reported in a proportion of imatinib-resistant and/or intolerant Philadelphia-positive chronic myeloid leukemia patients treated with nilotinib. Acute pancreatitis was very rare, and the relevance of these laboratory alterations remains unknown. We report on 8 chronic myeloid leukemia patients who developed serum lipase/amylase elevation during treatment with nilotinib. After a median follow-up of 26 months, none of these patients developed an acute pancreatitis or clinical signs of pancreatic disease. Pancreatic hyperenzymemia never led to permanent drug discontinuation and required nilotinib temporary interruption in one case only. The median cumulative duration of dose interruptions and response to treatment were comparable in patients with or without pancreatic enzyme elevation. The mechanisms of action of nilotinib on pancreatic enzymes deserves to be investigated: however, in our experience, the relevance of pancreatic hyperenzymemia was clinically very limited.

Key words: hyperlipasemia, hyperamylasemia, pancreatic enzymes, chronic myeloid leukemia, imatinib, nilotinib.