Aleem Aamer
Department of Medicine, Division of Hematology/Oncology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Hematol Oncol Stem Cell Ther. 2009;2(2):358-61. doi: 10.1016/s1658-3876(09)50026-x.
Hypopigmentation is an infrequently reported adverse effect of imatinib mesylate (IM) in chronic myeloid leukemia (CML), but there are no reports from Arab or Saudi patients. Thus, we assessed the frequency and impact of hypopigmentation in patients with chronic myeloid leukemia (CML) taking IM in our institution in Riyadh.
We studied 24 adult CML patients taking IM and followed from March to June 2008. Telephonic interviews with all the CML patients taking IM were conducted and case notes were reviewed. Findings were confirmed on a subsequent clinic visit by a physician. Demographic features, disease status, response to IM, presence and severity of skin changes and impact of these changes on the patients and the disease were noted.
Eight (33%) patients (6 males, 2 females) developed hypopigmentation due to IM. All patients had newly diagnosed, chronic phase CML and received 400 mg IM daily. The median age of the affected group was 37 years (range 18-54 years). Hypopigmentation developed during the first 3 months of treatment in 5 patients and 6 months or later in 3 patients. It was generalized in 7 patients and involved the hands and face in one patient. No photosensitivity was reported and none had other significant side effects.
Hypopigmentation of the skin can develop in about one third of CML patients taking IM. Physicians taking care of CML patients should be aware of this and patients need to be warned before commencing IM, particularly in dark-skinned patients.
色素减退是甲磺酸伊马替尼(IM)治疗慢性髓性白血病(CML)时一种较少报道的不良反应,但尚无来自阿拉伯或沙特患者的相关报道。因此,我们评估了利雅得我们机构中接受IM治疗的慢性髓性白血病(CML)患者色素减退的发生率及其影响。
我们研究了24例接受IM治疗的成年CML患者,随访时间为2008年3月至6月。对所有接受IM治疗的CML患者进行了电话访谈,并查阅了病历记录。随后由医生在门诊复诊时对结果进行确认。记录了人口统计学特征、疾病状态、对IM的反应、皮肤变化的存在及严重程度以及这些变化对患者和疾病的影响。
8例(占33%)患者(6例男性,2例女性)因IM出现色素减退。所有患者均为新诊断的慢性期CML,且每日接受400mg IM治疗。受影响组的中位年龄为37岁(范围18 - 54岁)。5例患者在治疗的前3个月出现色素减退,3例患者在6个月或更晚出现。7例患者为全身性色素减退,1例患者累及手部和面部。未报告有光敏反应,且均无其他明显副作用。
接受IM治疗的CML患者中约三分之一会出现皮肤色素减退。治疗CML患者的医生应意识到这一点,并且在开始使用IM之前需要对患者进行警告,尤其是对肤色较深的患者。