Changes from imatinib mesylate to second generation tyrosine kinase inhibitors improve renal impairment with imatinib mesylate in chronic myelogenous leukemia

Understanding adverse events in long-term tyrosine kinase inhibitor (TKI) therapy for chronic myelogenous leukemia (CML) is important. We investigated changes in renal function during TKI therapy for CML. We retrospectively analyzed levels of serum creatinine (sCrn) and values of estimated glomerular filtration rate (eGFR) from June 2001 to March 2015. Sixty patients initially treated with imatinib were enrolled in this study. Continuous variables of sCrn and eGFR were compared by paired student's t test. Median age or duration of treatment with imatinib was 49 years (range 19-81) or 101 months (range 8-165), respectively. Mean levels of sCrn or mean values of eGFR had increased or decreased 1 year later from start of imatinib throughout observation with statistical significance (p < 0.05), respectively. In 38 patients, the TKI used was changed from imatinib to a second-generation TKI (nilotinib: 32; dasatinib: 6) for various reasons. We observed statistically significant (p < 0.05) amelioration in mean levels of sCrn and values of eGFR after only 1 month following the changes to second-generation TKIs. These results suggest that imatinib has adverse effects on renal function and that changes from imatinib to a second-generation TKI should be considered as a therapeutic option in cases of renal impairment due to imatinib.