Impact of Imatinib on reducing the painful crisis in patients with sickle cell disease

Abstract

Introduction: Sickle cell disease (SCD) is a common hemoglobinopathy worldwide that causes painful crises and hospitalization of patients. These attacks decrease survival and cause chronic end-organ damage in these patients.

Hypothesis: For this reason, finding new treatment approaches could be helpful.

Method: In this study, Imatinib was applied as a mast cell inhibitor to reduce pain crises in these patients. Seven patients resistant to hydroxyurea and folic acid treatment and who had at least four painful crises per year with hospitalization were enrolled in this study with treatment with Imatinib (100 mg, twice daily). Subsequently, the number and duration of hospitalizations, analgesic requirement, the severity of chronic pain, and changes in the hematological parameters of these patients were evaluated before and after the treatment.

Results: The data showed that the total number of hospitalizations and the entire duration of hospitalizations were reduced 16 times after treatment with Imatinib, without apparent changes in hematological parameters. Also, the demand for pethidine, tramadol, and nonsteroidal anti-inflammatory drugs (NSAIDs) was reduced in all patients. The average reduction in chronic pain was over 70%.

Conclusion: This study demonstrates that treatment with Imatinib in patients with SCD or sickle cell anemia (SCA) may be a suitable therapeutic option for reducing painful crises.

Keywords: Analgesics; Hydroxyurea (HU); Imatinib; Painful crisis; Sickle cell anemia.

Figure 1

The statistical analysis (Median±SEM) of the hematological parameters of the studied patients with sickle cell diseases before and after treatment with imatinib (p-value < 0.05). The results did not show significant changes in the red blood cell (RBC) count, white blood cell (WBC) count, platelets, and hemoglobin (Hb) values before and after treatment with imatinib.