Congestive heart failure uncommon during imatinib therapy

September 11, 2007

NEW YORK (Reuters Health) - Congestive heart failure (CHF) occurs uncommonly during imatinib therapy for hematologic malignancies, according to a report in the August 15th issue of Blood.

"Imatinib remains a safe drug overall," Dr. Jorge Cortes from M. D. Anderson Cancer Center, Houston, Texas told Reuters Health. "Like with any medication, particularly in treating cancer patients, patients need to be monitored carefully to ensure the treatment is working well and not causing adverse events."

Dr. Cortes and associates investigated the incidence and significance of CHF in 1276 patients whose hematologic malignancy was treated with imatinib.

During a median follow-up of 47 months from the time imatinib was started, 22 patients (1.7%) were identified by the authors as having CHF. The median age of these 22 patients was 70 years.

The incidence of CHF increased with patient age, ranging from 0% among patients younger than 45 years and 0.3% among those between 45 and 55 years of age, to 9.3% among patients 76 to 85 years old.

Most of the patients (18/22, 82%) had previous cardiac conditions or other medical conditions that could be considered risk factors for cardiac disease, the researchers note.

Half of the patients who developed CHF were able to continue their imatinib therapy with dose adjustments and management of CHF symptoms without further complications.

The incidence of CHF was not related to the dose of imatinib received.

"At the present time, there is no indication for routine cardiac monitoring of all patients treated with imatinib," the investigators conclude.

Patients with a prior history of cardiovascular disease, however, "need particularly close monitoring and attention to any symptoms that may suggest worsening of their cardiac condition," Dr. Cortes said. "A baseline assessment of the cardiac status for these patients is important."