Persistent splenomegaly during imatinib therapy and the definition of complete hematological response in chronic myelogenous leukemia

Abstract

Splenomegaly belongs among typical findings on physical examination in patients with newly diagnosed chronic myelogenous leukemia (CML) [1]. Its disappearance is a part of achieving complete hematological response (CHR), that is nowadays (when second generation of tyrosine kinase inhibitors are available) of particular interest during imatinib treatment. However, the kinetics of the disappearance of splenomegaly in patients with CML has still never been studied. We have analyzed 20 out of 245 patients with newly diagnosed chronic phase CML that had a still palpable spleen at the 3rd month of imatinib therapy in terms of treatment response at 18 months from the start of therapy. Our analysis have showed that eight (40%) of these 20 patients had achieved a treatment response at these time points. Moreover 11 patients had still a palpable splenomegaly at the 6th month after the start of imatinib therapy and six (54%) of them had a therapeutic response at the 18th month, suggesting that slower spleen shrinkage in patients with newly diagnosed chronic phase CML does not necessarily mean the failure of the therapy in the future.