title: Efficacy and tolerability after unusually low doses of dasatinib in chronic myeloid leukemia patients intolerant to standard-dose dasatinib therapy.
abstract: We report our experience in 4 patients with chronic myeloid leukemia (CML) who had discontinued imatinib as a result of adverse events and had switched to dasatinib. The chronic phase (n 2) and accelerated phase (n 2) CML patients received dasatinib at starting dose of 100 and 140 mg once daily, respectively. Reappearance of hematological toxicity was observed in 3 patients and pancreatitis in one patient. Treatment was given at a lower dose and patients were followed. The median follow-up was 13 months and the median dose of dasatinib until achievement of complete cytogenetic remission (CCyR) was 60 mg daily (range = 20 to 120 mg). All four patients had achieved CCyR at a median of 4 months (range = 3 to 5 months) and among them, three had also achieved major molecular remission. We conclude that low-dose dasatinib therapy in intolerant patients appears safe and efficacious and may be tried before drug discontinuation.
authors.affiliation: Department of Hematology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Mariana
authors.initials: M
authors.lastname: Serpa
authors.forename: Sabri S
authors.initials: SS
authors.lastname: Sanabani
authors.forename: Israel
authors.initials: I
authors.lastname: Bendit
authors.forename: Fernanda
authors.initials: F
authors.lastname: Seguro
authors.forename: Flávia
authors.initials: F
authors.lastname: Xavier
authors.forename: Cláudia Bitti
authors.initials: CB
authors.lastname: Barroso
authors.forename: Monika
authors.initials: M
authors.lastname: Conchon
authors.forename: Pedro Enrique
authors.initials: PE
authors.lastname: Dorlhiac-Llacer