Marrow signal changes observed in follow-up whole-body MRI studies in children and young adults with neurofibromatosis type 1 treated with imatinib mesylate (Gleevec) for plexiform neurofibromas.

Abstract

BACKGROUND:

We observed bone marrow signal changes (BMSC) in patients with plexiform neurofibromas after treatment with imatinib mesylate (Gleevec).

OBJECTIVE:

To evaluate the pattern and natural history of BMSC.

MATERIALS AND METHODS:

The data were obtained from a pilot study of imatinib mesylate in patients with plexiform neurofibromas. All patients underwent baseline and sequential whole-body STIR 1.5-T MRI after treatment. The bone marrow signal on MRI was evaluated for abnormalities, location and pattern, and any change on follow-up studies.

RESULTS:

The study group included 16 patients (8 males) with a median age of 14 years (range 4 to 25 years). The mean whole-body MRI follow-up duration was 1.9 years. Of the 16 patients, 14 (88%) developed BMSC. The signal change was asymmetrical in 9 of the 14 patients (64%). The appendicular skeleton was involved in all 14 patients and the axial skeleton in 3 patients (21%). BMSC was followed in 13 patients and decreased signal was seen in 9 patients (69%) after a mean duration of 1.3 years of treatment (range 0.6 to 2.9 years); no complications were observed.

CONCLUSION:

BMSC appeared in most patients with neurofibromatosis type 1 following treatment with imatinib mesylate. BMSC was unusually asymmetrical and involved the lower extremities. On follow-up, BMSC often showed a decrease without complications.

• Authors: Boaz Karmazyn, Mervyn D Cohen, Samuel Gregory Jennings, Kent A Robertson
• Journal: Pediatric radiology (Pediatr Radiol) Vol. 42 Issue 10 Pg. 1218-22 (Oct 2012) ISSN: 1432-1998 [Electronic] Germany
• PMID: 22722872 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antineoplastic Agents
• Benzamides
• Piperazines
• Pyrimidines
• Imatinib Mesylate

Topics

• Adolescent
• Adult
• Antineoplastic Agents (therapeutic use)
• Benzamides
• Bone Marrow (drug effects, pathology)
• Child
• Child, Preschool
• Female
• Humans
• Imatinib Mesylate
• Magnetic Resonance Imaging (instrumentation)
• Male
• Neurofibroma, Plexiform (drug therapy, etiology, pathology)
• Neurofibromatosis 1 (complications, drug therapy, pathology)
• Pilot Projects
• Piperazines (therapeutic use)
• Pyrimidines (therapeutic use)
• Treatment Outcome
• Whole Body Imaging (methods)
• Young Adult