Gelatinous Marrow Transformation Associated with Imatinib: Case Report and Literature Review

Table 1

Clinical characteristics of patients with gelatinous marrow transformation and CML treated with imatinib.

Case	Author	Age, gender	Cytopenias	Dose and duration of therapy	Status of disease	Outcome	Comorbidities
1	Hong et al. [6]	57, male	Anemia, leukopenia	1 year (400 mg daily)	MMR 1 year earlier^1	Lowered the dose to 300 mg due to bicytopenia	None: no weight loss or malnutrition
2	Hong et al. [6]	23, female	None	22 months (400 mg daily)	MMR	Stopped imatinib (per patient request), underwent allogeneic transplant	None: no weight loss or malnutrition
3	Agrawal et al. [7]	44, male	None	11 months (400–600 mg daily)	CCyR, MMR	Remains in MMR after 7 years of imatinib	None: no weight loss, malnutrition, or dementia
4	Srinivas et al. [8]	60, male	Pancytopenia	3 years (400 mg daily)	CHR; CCyR 1 year earlier	At 4-month follow-up, leukopenia and mild thrombocytopenia persisted, and imatinib therapy continued	Transitional cell carcinoma of bladder, sepsis, disseminated intravascular coagulation, renal failure
5	Ram et al. [5] and Thakral et al. [9]	Unknown	Grade 2 cytopenias	Unknown	Unknown	Unknown	Unknown
6	Seaman et al. [10]	67, male	Pancytopenia	4 months	No cytogenetic response	Imatinib discontinued, replaced w/nilotinib Subsequent marrows showed restitution of cellularity, but patient continued to have residual disease by RT-PCR or FISH at 8 months	Unknown
7	Our case	78, male	Anemia, thrombocytopenia	Intermittent for years, then 8 months at 400 mg daily	BCR-ABL increasing	Remained off TKIs CML progressed but patient died of other causes	Dementia, diabetes mellitus; No weight loss or malnutrition

At time of bone marrow biopsy, the patient was at least in CHR.
CHR = complete hematological remission; MMR = major molecular response; CCyR = complete cytogenetic response.