title: Successful treatment of extramedullary blast crisis of chronic myelogenous leukemia with imatinib mesylate (STI571).
abstract: We describe a patient with chronic myelogenous leukemia (CML) who developed extramedullary blast crisis, and was successfully treated with imatinib mesylate (STI571). A 42-year-old man had been diagnosed with chronic phase Philadelphia chromosome (Ph)-positive CML and treated with interferon-alpha. He achieved partial cytogenetic response. Two years after the diagnosis, he presented with superficial lymphadenopathy in his neck and supraclavicular regions. Lymph node biopsy disclosed the infiltration of myeloblasts. Although the patient's bone marrow was without increasing blasts at that time, cytogenetic response was no longer observed. STI571 at a dose of 600 mg/day was initiated, and led to the complete disappearance of lymphadenopathy within a month and also to major cytogenetic response in the bone marrow (90% Ph-negative metaphases). Subsequently, the patient underwent allogeneic bone marrow transplantation from an HLA-matched unrelated donor and was in complete remission without evidence of extramedullary disease 12 months after transplantation.
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Naito
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Keiko
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Yuiko
authors.initials: Y
authors.lastname: Tsukada
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D001752:Blast Crisis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D001856:Bone Marrow Examination; D016026:Bone Marrow Transplantation / Q000379:methods; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D009333:Neck; D010879:Piperazines / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases