Effect of Imatinib therapy on liver enzymes and serum bilirubin in CML Iraqi patients


Background: The treatment of chronic myeloid leukemia (CML) has been revolutionized by Imatinib. Imatinib is a selective inhibitor of the BCR-ABL tyrosinkinase, it produce high response rate in patients with CML who have no response to interferon alfa. Imatinib is occasionally associated with hepatotoxicity. Objectives: The aim of this research is to study the effect of Imatinib therapy on liver enzymes and serum bilirubin in patients diagnosed in chronic phase myeloid leukemia.Methods: A sample of 100 Iraqi patients diagnosed with CML, selected at random, at the National Hematology Center in Baghdad were included for the period from August till the end of October 2008. They were diagnosed by peripheral blood and bone marrow aspirate examination and real-time PCR. 98 patients were started on Imatinib mesylate 400 mg and only 2 patients were started on oral 300 mg daily. Liver enzymes and serum bilirubin were measured before starting treatment and after three months of continuing on treatment.Results: Median age of patients was 35.5 years with 48 males and 52 females. The frequency of CML cases by residence was 46% from Baghdad and 54% from other regions of Iraq. The level of liver enzymes, serum alanine aminotransferase and serum aspartate aminotransferase was normal, serum alkaline phosphatase was normal in 94 patients, 5 patients had serum alkaline phosphatase less than 2 times elevated and one patient (18 years old) had 2 times elevates serum alkaline phosphatase level. The total serum bilirubin was normal in all patients.Key words: Imatinib, Liver enzymes