Pre-emptive treatment with nilotinib after second allogeneic transplantation in a Philadelphia chromosome-positive acute lymphoblastic leukemia patient with high risk of relapse.
Although a tyrosine kinase inhibitor (TKI) targeted for BCR/ABL administered in combination with chemotherapy has been established as the current first-line strategy for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), relapse remains common, even among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Recently, preclinical and preliminary clinical studies suggested a potential therapeutic role of nilotinib, a second-generation TKI, in Ph+ ALL, including patients who have undergone prior allo-HSCT. This report presents the case of a patient with a post-transplant persistent positive BCR/ABL value, who was treated with imatinib and dasatinib before a second allo-HSCT. The patient started taking nilotinib due to a persistent BCR/ABL value and residual mass in her ovaries after a second allo-HSCT. Nine months after introducing nilotinib, the patient achieved complete molecular remission, and despite the continued existence of the residual ovary mass, no hot spot was found in her positron emission tomography scan. The present paper also reviews existing literature on the pre-emptive use of nilotinib for Ph+ ALL patients who received all-HSCT.
Kang
Byung Woog
BW
Department of Hematology/Oncology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
Moon
Joon Ho
JH
Chae
Yee Soo
YS
Kim
Jong Gwang
JG
Kim
Shi-Nae
SN
Sohn
Sang Kyun
SK
D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000517:prevention & control*; D011743:Pyrimidines / Q000008:administration & dosage*; D012008:Recurrence; D012074:Remission Induction; D014184:Transplantation, Homologous
D011743:Pyrimidines; C498826:nilotinib