Background: We analyzed the incidence of acute kidney injury and chronic renal failure in chronic myeloid leukemia (CML) patients using imatinib and investigated whether there is a relation between duration of imatinib therapy and decrease in estimated glomerular filtration rate (GFR). Patients and methods: One hundred five CML patients on imatinib therapy were enrolled. Creatinine, urea, uric acid, and potassium measurements from imatinib treatment onset until the end of follow-up (median 4.5 years) were included in the analysis. GFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Results: During follow-up,7%of patients developed acute kidney injury; creatinine levels returned to baseline in only one of them. According to the regression equation, the mean baseline value of the estimated GFR was 88.9 ml/min/1.73m2. Estimated GFR decreased significantly with imatinib treatment duration; the mean decrease per year was 2.77 ml/min/1.73 m2(P < 0.001); 12% of patients developed chronic renal failure. Age, hypertension, and a history of chronic renal failure or interferon usage were not significantly related to the mean decrease in the estimated GFR over time. Conclusion: The introduction of imatinib therapy in nonclinical trial CML patients is associated with potentially irreversible acute renal injury, and the long-term treatment may cause a clinically relevant decrease in the estimated GFR.

Acute kidney injury, Adverse effects, Chronic renal failure, Drug-induced nephrotoxicity, Imatinib, Protein kinase inhibitors,
Annals of Oncology
Erasmus MC: University Medical Center Rotterdam

Marcolino, M.S, Boersma, H, Clementino, N.C.D, Macedo, A.V, Marx-Neto, A.D, Silva, M.H.C.R, … Ribeiro, A.L. (2011). Imatinib treatment duration is related to decreased estimated glomerular filtration rate in chronic myeloid leukemia patients. Annals of Oncology, 22(9), 2073–2079. doi:10.1093/annonc/mdq715