The effects of imatinib exposure prior to allogeneic transplantation on hematopoietic reconstruction and early complications in chronic myeloid leukemia patients

Abstract

Objective To investigate the effects of exposure to imatinib prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) on hematopoietic reconstruction and early transplantrelated complications for chronic myeloid leukemia (CML) patients.Methods 97 CML patients' clinical data who underwent allo-HSCT in Nanfang Hospital from May 2003 to May 2013 were analyzed retrospectively.The patients were divided into imatinib group (27 patients) and control group (70 patients) and their hematopoietic reconstruction time,prognosis and the incidence of early transplant-related complications (±100 day) such as acute hearrtfailure,hepatic veno-occlusive disease (HVOD),graft versus host disease (GVHD),hemorrhagic cystitis and infections were compared.Results Compared with control group,imatinib group neither had a significantly longer hematopoietic reconstruction time nor higher incidence of HVOD,GVHD,hemorrhagic cystitis and infections (P ＞ 0.05).However,imatinib group tended to have a statistically higher incidence of acute hearrtfailure [29.6 ％ (8/27) vs 8.6 ％ (6/70),P =0.02] and higher rate of mortality and withdrawal of treatment [18.5 ％ (5/27) vs 2.9 ％ (2/70),P =0.02].Conclusions Imatinib treatment prior to transplantation probably increases the incidence of acute hearrtfailure and induces adverse prognosis.But it does not influence hematopoietic reconstruction or the incidence of early transplant-related complications such as HVOD,GVHD,hemorrhagic cystitis and infections. Key words: Imatinib; Leukemia, myelogenous, chronic; Hematopoietic stem cell transplantation; Hematopoietic reconstitution; Heart Failure; Early transplant-related complications