Efficacy of imatinib mesylate (STI571) in chronic neutrophilic leukemia with t(15;19): case report.
Chronic neutrophilic leukemia (CNL) is a rare hematologic disorder, for which there is no standard therapy. Recently, STI (imatinib mesylate) has been shown to be effective in treating patients with chronic myeloproliferative disorder (CMPD) displaying the translocation of the PDGFbetaR gene. Here, we present a case of a patient with CNL carrying t(15;19)(q13;p13.3) who achieved a cytogenetic remission following treatment with imatinib, 400 mg daily. After failure of alpha interferon and hydroxyurea therapy, a durable and complete clinical and cytogenic remission was induced by imatinib. To our knowledge, this is the first case with CNL who showed complete response with cytogenic remission after treatment of imatinib. The mechanism of response to this molecule is unknown in our case (other oncogenes than c-kit, tyrosine kinase, or PDGFR may be involved). The patient remains in complete remission with an excellent performance status after 7 months of therapy. We demonstrate here that imatinib can induce a clinical and cytogenetic response in a case of CNL associated with a novel translocation other than a 5q33 rearrangement. Further studies including the molecular cloning of the t(15;19)(q13;p13.3) will be important in understanding the pathophysiology of CNL with a heterogeneous clinical course and the exploitation of the basic mechanisms of imatinib treatment.
Choi
In Keun
IK
Division of Oncology and Hematology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
Kim
Byung-Soo
BS
Lee
Kyung-A
KA
Ryu
Sookwon
S
Seo
Hee Yun
HY
Sul
Hyeryoung
H
Choi
Jong Gwon
JG
Sung
Hwa Jung
HJ
Park
Kyong Hwa
KH
Yoon
So Young
SY
Oh
Sang Cheul
SC
Seo
Jae Hong
JH
Choi
Chul Won
CW
Shin
Sang Won
SW
Yoon
Soo-Young
SY
Cho
Yunjung
Y
Kim
Young-Kee
YK
Kim
Yeul Hong
YH
Kim
Jun Suk
JS
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001549:Benzamides; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D015467:Leukemia, Neutrophilic, Chronic / Q000097:blood / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D020797:Receptor, Platelet-Derived Growth Factor beta / Q000235:genetics*; D012074:Remission Induction; D014178:Translocation, Genetic; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D020797:Receptor, Platelet-Derived Growth Factor beta