DOI: 10.36347/sajb.2019.v07i07.004

Pages: 306-312

CML is a common haematological malignancy characterized by the BCR-ABL fusion gene and treated by the tyrosine kinase inhibitor imatinib which has also been shown to inhibit other tyrosine kinases involved in multiple endocrine functions. IGF-1 as a part of Growth hormone IGF-1 axis is involved in bone growth and haematopoiesis. IGF-1 deregulation has been shown to be associated with multiple cancers and CML. Further it is postulated to have a role in blast crisis transformation of CML and its metabolism may be affected by imatinib. All these intriguing interactions and lack of studies on status of serum IGF-1 in CML patients and the effect of imatinib therapy on them inspires this study. The study was designed to prospectively study serum IGF-1 levels at baseline and at 6 months of imatinib treatment in 30 newly diagnosed BCR-ABL positive CML patients. IGF-1 levels were measured with commercial ELISA kit. Of the 30 CML patients (17M & 13F), 2 patients presented in accelerated phase and 26 achieved haematological remission by 6 months. There was no significant difference in serum IGF-1 levels in patients (186.8±42.0 ng/mL) and controls (173.0±53.1 ng/mL). Mean baseline levels in 4 patients not achieving hematological remission by 6 months were 203.6±28.4 ng/mL as compared to 184.3±43.5 ng/mL in the rest achieving hematological remission. Serum IGF-1 levels decreased significantly with age in both controls (r2 = 0.309, p<0.001) and patients (r2 = 0.314, p<0.001). Serum IGF-1 levels decreased significantly after 6 months of imatinib therapy in patients in hematological remission (104.9±43.8 ng/mL vs. 184.3±43.6 ng/mL, p <0.001). Significantly decreased serum IGF-1 levels after 6 months of imatinib therapy reflect the GH deficiency induced by imatinib therapy in the adult CML patients. Further longitudinal studies in larger number of patients are required to assess the clinical significance of GH and IGF-1 deficiency in adult CML patients on imatinib therapy and specu