Author Reply

Leong et al. reported that 65% of patients in their Gleevec International Patient Assistance Program developed skin hypopigmentation due to imatinib mesylate therapy, primarily among ethnically Chinese patients with accelerated or interferon-resistant disease. However, a case series of six African-American patients and additional cases at the University of Texas M. D. Anderson Cancer Center did not show a similar association. The variability in skin hypopigmentation might be due to ethnic differences or the fair-skinned population at the latter institution. The hypopigmentation is likely linked to the suppression of c-Kit tyrosine kinase activity by imatinib mesylate, affecting melanocyte function. The authors advised against using imatinib mesylate as a lightening agent for hyperpigmented areas due to its systemic effects and recommended avoiding sun exposure for affected patients.