12th Congress of the European Hematology ... - Haematologica

maintained on Imatinib 400 mg. After one year on imatinib, she presented
with tiredness and weight gain and a raised TSH level of 42.1 miu/L.
The dose of Levothyroxine was increased to 150 micrograms daily, with
a reduction in the TSH levels to 12.7 miu/L and improvement in her
symptoms. Three months later, the TSH levels elevated to 25.1 miu/L.
She was also found to have Thyroglobulin antibodies of 152 units. The
dose of Levothyroxine was further increased to 175 micrograms daily,
two months later to 200 micrograms daily but her hypothyroidism
remains increasingly difficult to treat. Meanwhile, she continues on Imatinib
400mg daily. This is the first case of hypothyroidism following
Imatinib treatment in a patient who had not undergone a thyroidectomy.
It has been suggested by Willem et al. 2000 that the most likely
mechanism that contributes to Imatinib-induced hypothyroidism
involves stimulation of T4 and tri-iodothyroxine (T3) clearance. We
would recommend regular thyroid function tests in patients taking Imatinib
with or without thyroidectomy.
Reference
1. Willem J B. de Groot, MD, Bernard A. Zonnenberg, MD, John T.M. Pluker,
MD, PhD, Winette T.A. van Der Graff, MD, PhD and Thera P. Links,
MD, PhD (2002) Imatinib induces hypothyroidism in patients receiving
Levothyroxine. Clinical Pharmacology Grand Rounds.
1505
TREATMENT OUTCOME OF PATIENTS RECEIVING IMATINIB FOR CHRONIC MYELOID
LEUKEMIA AS FIRST OR SECOND LINE THERAPY
C.A. De Souza, K.B.B. Pagnano, M.T. Delamain, I. Lorand-Metze,
E.C.M. Miranda, R.A. Silveira, K. Metze
State University of Campinas, CAMPINAS, Brazil
Background. Imatinib is currently the first line treatment for CML
patients. In Brazil until recently patients have used imatinib after Interferon
failure or intolerance. Methods. retrospective analysis of 139
patients with CML that received imatinib as first or second line therapy
from December 2000 to November 2006. Patients were evaluated with
overall and event-free survival; progression to accelerated-phase CML or
blast crisis; hematologic, cytogenetic, and molecular responses and resistance.
Results. sixty-one patients (44%) were previously treated with
Hydroxiurea (HU), 65 with HU+IFN (47%) and 10 with other treatments
(three with autologous bone marrow transplantation). When patients
started imatinib, 90 were in CP, 31 in AP and 18 in BC. 115 patients
(83%) achieved hematologic response, 46 of 91 (50,5%) achieved complete
cytogenetic response (CCR) and 19 of 91 (20,9%) partial cytogenetic
response (PCR). Molecular response was accessed in 73 patients
and 25 (34,2%) achieved major molecular response. Sokal and Hasford
score were associated with achievement of cytogenetic response
(p=0,001 and p20 ×10 9 /L (n=44) recovery rate is
63,61±1,86%, lymphocyte recovery -68,15 ±2,39% (p