title: The CNS is a sanctuary for leukemic cells in mice receiving imatinib mesylate for Bcr/Abl-induced leukemia.
abstract: The chronic myelogenous leukemia (CML)-like myeloproliferative disorder observed in the BCR/ABL murine bone marrow transduction and transplantation model shares several features with the human disease, including a high response rate to the tyrosine kinase inhibitor imatinib mesylate (STI571). To study the impact of chronic imatinib mesylate treatment on the CML-like illness, mice were maintained on therapeutic doses of this drug and serially monitored. Unexpectedly, despite excellent systemic control of the CML-like illness, many of the mice developed progressive neurologic deficits after 2 to 4 months of imatinib mesylate therapy because of central nervous system (CNS) leukemia. Analysis of imatinib mesylate cerebral spinal fluid concentrations revealed levels 155- fold lower than in plasma. Thus, in the mouse, the limited ability of imatinib mesylate to cross the blood-brain barrier allowed the CNS to become a sanctuary for Bcr/Abl-induced leukemia. This model will be a useful tool for the future study of novel anti-CML drugs and in better defining the mechanisms for limited imatinib mesylate penetration into the CNS.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas 75390, USA.
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Wolff
authors.forename: James A
authors.initials: JA
authors.lastname: Richardson
authors.forename: Merrill
authors.initials: M
authors.lastname: Egorin
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ilaria
mesh_terms: D000818:Animals; D001549:Benzamides; D001812:Blood-Brain Barrier; D001853:Bone Marrow; D001932:Brain Neoplasms / Q000473:pathology*; D002493:Central Nervous System Diseases; D016313:Genes, abl / Q000235:genetics*; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D051379:Mice; D008807:Mice, Inbred BALB C; D009368:Neoplasm Transplantation; D010879:Piperazines / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics* / Q000627:therapeutic use; D011743:Pyrimidines / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics* / Q000627:therapeutic use; D013120:Spinal Cord Neoplasms / Q000473:pathology*; D014162:Transfection
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate