Favorable outcome with STI571 (imatinib mesylate) and allogeneic stem cell transplantation in a case of Ph+ chemorefractory acute lymphocytic leukaemia.
We present a patient with a Philadelphia chromosome positive (Ph+) acute lymphocytic leukaemia (ALL) refractory to standard induction chemotherapy. Treatment with the ABL-specific tyrosine kinase inhibitor STI571 (Glivec, Gleevec, imatinib mesylate) resulted in a complete haematologic and cytogenetic remission. Allogeneic stem cell transplantation from an unrelated donor could be undertaken while the patient was in STI571-induced complete remission from the leukaemia. At present, the patient has a 15-month post-transplantation follow-up and is in stable molecular remission as evaluated by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) for the BCR/ABL fusion gene transcript. Our case demonstrates that STI571 can act as a bridge to potentially curative allogeneic stem cell transplant in otherwise poor prognosis Ph+ ALL.
Wernstedt
P
P
Hematology Section, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
Brune
M
M
Andersson
P-O
PO
Gustavsson
B
B
Stockelberg
D
D
Wadenvik
H
H
D000328:Adult; D000677:Amsacrine / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001549:Benzamides; D001623:Betamethasone / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000235:genetics; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D000068877:Imatinib Mesylate; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008942:Mitoxantrone / Q000008:administration & dosage; D018365:Neoplasm, Residual; D036102:Peripheral Blood Stem Cell Transplantation; D010879:Piperazines / Q000627:therapeutic use*; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000628:therapy; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014184:Transplantation, Homologous; D014750:Vincristine / Q000008:administration & dosage
D000970:Antineoplastic Agents; D001549:Benzamides; D014408:Biomarkers, Tumor; D004791:Enzyme Inhibitors; D007166:Immunosuppressive Agents; D010879:Piperazines; D011743:Pyrimidines; D000677:Amsacrine; D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D000068877:Imatinib Mesylate; D003520:Cyclophosphamide; D001623:Betamethasone; D008942:Mitoxantrone; D016044:Fusion Proteins, bcr-abl; D003630:Daunorubicin