The effect of imatinib mesylate treatment on osteoporosis in patients with chronic myeloid leukemia

Chronic Myeloid Leukemia (CML) is a clonal disorder in which cells of the myeloid serie undergo excessive proliferation. The characteristic genetic abnormality of the disease, the Philadelphia (Ph) chromosome, results from a reciprocal translocation between the long arms of chromosomes 9 and 22. The molecular consequence of this translocation is the production of fusion protein BCR-ABL, which is a constitutively activated tyrosine kinase, and present in all of patients with CML.Current therapies of the disease include allogeneic stem cell transplantation and drug regimens including imatinib mesylate. Allogeneic bone marrow or stem cell transplantation, which is the only curative treatment for CML, is associated with substantial morbidity and mortality and it is limited to patients who have a suitable donor. Imatinib mesylate is an effective agent in treating CML by targeting the constitutively active tyrosine-kinase domain of BCR-ABL and it has been used currently as a first-line therapy in the patients who don?t have any suitable donor for allogeneic stem cell transplantation.The aim of our study is to determine possible effect of use of imatinib on osteoporosis via comparing femur T score and vertebra T score values of CML group and control group.This study was performed on 20 patients with CML and 20 people in control group who visited Turgut Ozal Medical Center between April 2008 and October 2008, prospectively.In the result of the study, statistically significant difference was found between the two groups for their serum P values (p<0.05). Average of serum P values was less in CML group than control group. However there is no significant difference between the two groups for other parameters, including femur T score and vertebra T score.The significant correlation between hypophosphatemia and the use of imatinib which has been determined in our study was harmonious with outcomes of previous studies, even though we have few medical cases in this study.Consequently, we didn?t observe a statistically significant correlation between the use of imatinib and osteoporosis development in our study. More comprehensive researches are needed to show the effects of imatinib on bone remodeling.