The Negative Impact of Imatinib Mesylate Therapy Prior to Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Chronic Myeloid Leukemia

Background: In patients with chronic myeloid leukemia subjected to allogeneic hematopoietic stem cell transplant, the possible negative impact of imatinib therapy in the pre-transplant period is still controversial. Methods and materials: A retrospective study of patients with chronic myeloid leukemia who received allogeneic hematopoietic stem cell transplant between January 2004 and December 2006 at King Faisal Specialist Hospital and Research Centre in Riyadh was conducted. The results of patients who received hydroxyurea or interferon-α (group A) prior to transplant were compared with those of patients who received imatinib therapy (group B). Both groups of patients received the same conditioning therapy and graft versus host disease prophylaxis. Results: Survival was shorter and mortality rate was higher in group B compared to group A patients. Both acute and chronic graft versus host disease were not only more frequent but also more severe and extensive in group B. Viral, bacterial and fungal infections were more predominant and more serious in group B compared to group A. Conclusions: In patients with chronic myeloid leukemia who are subjected to hematopoietic stem cell transplant, prior therapy with imatinib mesylate may have an adverse outcome in terms of survival, graft versus host disease and post-transplant infectious complications.