Durable molecular response to imatinib mesylate following nonmyeloablative allogeneic stem-cell transplantation for persisting myeloid blast crisis in chronic myeloid leukemia.
We report a chronic myeloid leukemia (CML) patient in chronic phase (CP) who developed blast crisis (BC) under imatinib mesylate administered in a dose reduced and non-continuous fashion because of hematologic intolerance. The patient underwent nonmyeloablative stem-cell transplant from a matched unrelated donor, but failed to achieve full donor chimerism and antileukemic response resulting in persistence of advanced disease. Complete hematologic, cytogenetic and molecular responses were attained 5 weeks after readministration of regularly dosed imatinib and two-step nested RT-PCR confirmed molecular remission throughout a 6 month follow-up period. This is the first case demonstrating that imatinib mesylate is a highly effective and safe treatment option to induce durable molecular remission in patients with CML who remain in myeloid blast crisis after nonmyeloablative allogeneic stem-cell transplantation.
Staber
Philipp B
PB
Division of Hematology, Dept. of Internal Medicine, Karl Franzens University Graz, Austria.
Brezinschek
Ruth
R
Linkesch
Werner
W
Sill
Heinz
H
Neumeister
Peter
P
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D001752:Blast Crisis / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000187:drug effects*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents; D001549:Benzamides; D019653:Myeloablative Agonists; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate