Imatinib: in relapsed or refractory Philadelphia chromosome-positive acute lymphoblastic leukaemia.
* Imatinib inhibits the breakpoint cluster region-Abelson (BCR-ABL) tyrosine kinase, which is produced by the chromosomal abnormality known as the Philadelphia (Ph) chromosome in patients with Ph chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL). * The clinical efficacy and safety of oral imatinib in patients with relapsed or refractory Ph+ ALL has been demonstrated in a noncomparative, open-label phase II trial (n = 48) and an expanded-access study (n = 353). The majority of patients received imatinib 600mg once daily. * In the phase II trial, imatinib induced complete haematological responses in 19% of patients, marrow complete responses in 10% of patients and partial marrow responses in 31% of patients. These were sustained for at least 4 weeks in 27% of patients. * The estimated median times to progression were 2-3.1 months in the phase II trial, the expanded-access study and a population of 68 patients pooled from these studies, with estimated median overall survival rates of 4.9-9 months. * In 22 patients receiving imatinib prior to undergoing allogeneic stem cell tranplantation (SCT) in the phase II trial and expanded-access study, estimated disease-free survival and overall survival rates 12 months after SCT were 25.5% and 44.8%. * Although adverse events were frequent among relapsed or refractory Ph+ ALL patients treated with imatinib, the majority of non-haematological adverse events were mild or moderate in severity.
Cross
Sarah A
SA
Wolters Kluwer Health | Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Conshohocken, Pennsylvania, USA. demail@adis.co.nz
Lyseng-Williamson
Katherine A
KA
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001549:Benzamides; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D006801:Humans; D000068877:Imatinib Mesylate; D010677:Philadelphia Chromosome; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000235:genetics*; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D012008:Recurrence; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate