Effect of long term imatinib on bone in adults with chronic myelogenous leukemia and gastrointestinal stromal tumors

Leuk Res. 2013 Jul;37(7):790-4. doi: 10.1016/j.leukres.2013.02.005. Epub 2013 Mar 6.


Patients with chronic myelogenous leukemia (CML) or gastrointestinal stromal tumors (GIST) who take imatinib have abnormalities of bone metabolism. However, it is unclear what impact these changes have on bone mineral density (BMD). We prospectively analayzed levels of osteocalcin, a marker of bone formation secreted by osteoblasts, and serum N-telopeptide of type I collagen (NTX), a marker of bone resorption, as well as other minerals involved in bone metabolism in 19 patients with either CML or GIST We correlated these results with changes in bone mineral density as measured by serial dual energy X-ray absorptiometry (DEXA) scans over a two year period. Osteocalcin levels were low in 95% of patients and 37% had no measurable amount. Levels of NTX were less consistent. Nine patients (47%) had a decrease in BMD, four patients (2%) had an increase in BMD, and six patients (32%) had no change. There was no correlation between metabolic markers and change in BMD. We suggest that ongoing management of patients who take imatinib should include monitoring of bone health on a long term basis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Benzamides / adverse effects*
  • Biomarkers / metabolism
  • Bone Density / drug effects*
  • Bone Resorption / chemically induced*
  • Bone Resorption / diagnosis
  • Bone Resorption / metabolism
  • Collagen Type I / metabolism
  • Female
  • Follow-Up Studies
  • Gastrointestinal Stromal Tumors / complications*
  • Gastrointestinal Stromal Tumors / drug therapy
  • Gastrointestinal Stromal Tumors / mortality
  • Humans
  • Imatinib Mesylate
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality
  • Male
  • Middle Aged
  • Osteocalcin / metabolism
  • Osteogenesis / drug effects*
  • Peptides / metabolism
  • Piperazines / adverse effects*
  • Prognosis
  • Prospective Studies
  • Pyrimidines / adverse effects*
  • Survival Rate
  • Young Adult


  • Antineoplastic Agents
  • Benzamides
  • Biomarkers
  • Collagen Type I
  • Peptides
  • Piperazines
  • Pyrimidines
  • collagen type I trimeric cross-linked peptide
  • Osteocalcin
  • Imatinib Mesylate