Heterogeneity of response to imatinib-mesylate (glivec) in patients with hypereosinophilic syndrome: implications for dosing and pathogenesis.
Four cases of hypereosinophilic syndrome (HES) treated with the tyrosine-kinase inhibitor imatinib-mesylate are reported. The drug was effective in three patients, but a prolonged clinical and hematological remission was obtained only in one patient, due to appearance of resistance or poor tolerability in the other cases. The dose of imatinib necessary to achieve a response ranged from 100 to 600 mg/d. One patient with evidence of a clonal T-cell population did not respond at all. We confirm the efficacy of imatinib in HES, but we also underline that type and duration of response may be variable. This could be due to different pathogenetic mechanisms of the disease in single patients.
Musto
Pellegrino
P
Unit of Hematology and Stem Cell Transplantation, IRCCS "Casa Sollievo della Sofferenza", 71013 S. Giovanni Rotondo, Italy. p.musto@tin.it
Falcone
Antonietta
A
Sanpaolo
Grazia
G
Bodenizza
Carlo
C
Perla
Gianni
G
Minervini
Maria Marta
MM
Cascavilla
Nicola
N
Dell'Olio
Matteo
M
La Sala
Antonio
A
Mantuano
Saverio
S
Melillo
Lorella
L
Nobile
Michele
M
Scalzulli
Potito Rosario
PR
Bisceglia
Michele
M
Carella
Angelo Michele
AM
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D013601:T-Lymphocytes / Q000473:pathology; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D004791:Enzyme Inhibitors; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases