Objective To describe the occurrence of hematologic toxicity in patients with gastrointestinal stromal tumors receiving imatinib in the real world,and to explore influence factors of hematologic toxicity.Method The characteristics and imatinib treatment data of 566 patients with gastrointestinal stromal tumors from July 2017 to December 2021 in the First Affiliated Hospital of Sun Yat-sen University were collected,and the incidence of hematological toxicity after receiving imatinib was counted.The effects of gender,age,tumor primary location,treatment stage and imatinib plasma trough concentration on hematological toxicity were analyzed.The efficiency of imatinib plasma trough concentration in predicting severe hematological toxicity was evaluated using receiver operating characteristic curve.Result The most common hematological toxicity was anemia(56.4％),followed by leukopenia(47.0％),similar incidence of neutropenia and lymphocytopenia(31.4％and 30.9％),and low incidence of thrombocytopenia(3.5％).The incidences of hematological toxicities of grade 3 or above were less than 5％.Univariate binary Logistic regression analysis showed that female was a risk factor for neutropenia(OR=1.697,95％CI 1.187-2.428,P=0.004).Multivariate binary Logistic regression showed that female was an independent risk factor for leukopenia(OR=2.333,95％CI 1.658-3.283,P＜0.001).Female(OR=1.450,95％CI 1.021-2.058,P=0.038),age≥60 years old(OR=1.868,95％CI 1.308-2.666,P=0.001),imatinib plasma trough concentration quartile increase were independent risk factors of anemia.For each quartile increase in imatinib plasma trough concentration,the risk of anemia became 1.278 times greater(95％CI 1.095-1.492,P=0.002).The optimal cut-off value of imatinib plasma trough concentration for predicting severe anemia was 1428 μg/L,with the sensitivity,specificity,Jorden index and area under the curve were 0.500,0.725,0.225 and 0.622,respectively(P=0.029).Conclusion Imatinib had good safety in the treatment of gastrointestinal stromal tumors.Hematological toxicities were usually mild,mostly grade 1-2,with a few of grade 3 or above.For patients with gastrointestinal stromal tumor received imatinib,regular blood routine and pharmaceutical care including therapeutic drug monitoring should be performed to detect and manage hematological toxicity in time.
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