Brain Natriuretic Peptide (BNP) Level as Marker of Cardiac Function in Imatinib - Treated Chronic Myeloid Leukemia Patients: No Evidence of Cardiotoxicity of Imatinib Therapy.

In the last year, the issue of cardiotoxicity of imatinib mesylate (IM) was on focus. Emerging data seem to deny an increased risk of cardiac events in patients treated with IM, which is the frontline therapy in chronic myeloid leukemia (CML). B-type natriuretic peptide (BNP) is released by the heart in response to myocardial tension and is considered an accurate test for the diagnosis of heart failure. The measurement of BNP in the serum is a rapid and easy tool for evaluation of ventricular function, also in asymptomatic patients. We have measured BNP level in 50 consecutive patients (33 males and 17 females) with IM treated chronic phase CML. Patients were enrolled, after informed consent was obtained, as they presented for a follow-up visit at our Institution. BNP was measured using a direct chemiluminescent sandwich immunoassay: the analytical range extends from 0 to 5000 pg/ml, with a sensitivity 100 pg/ml. There was a linear correlation between age and BNP levels (t–value=3.850, p=0.0003). Nine out of 24 (37%) patients aged ≥60 had BNP >22 pg/ml, compared to only 1/25 (4%) in the cohort 2 =19.7, p 400 = 13.5±9.3) or by therapy duration (