title: Eradication of T315I mutation in chronic myeloid leukemia without third-generation tyrosine kinase inhibitor: a case report.
abstract: We report the case of a patient bearing a T315I-mutant chronic myeloid leukemia resistant to nilotinib, successfully treated with omacetaxine and then with dasatinib. After 9 months of nilotinib, the patient achieved a major molecular response but relapsed 3 months later due to the T315I mutation. Because third-generation tyrosine kinase inhibitor was not available and the patient refused bone marrow transplantation, he received two cycles of omacetaxine. This treatment had been stopped after two cycles because of clinical intolerance, but a major molecular response and total disappearance of the T315I clone was obtained. Treatment with dasatinib was then started and after 34-month follow-up the patient is still in major molecular response, thus suggesting that eradication of the T315I mutation could be achieved without third-generation tyrosine kinase inhibitors.
authors.affiliation: 1UMR1090 TAGC, INSERM, Marseille, France.|2UMR1090 TAGC, Aix-Marseille Université, Marseille, France.|3Service d'hématologie, APHM, La Conception University Hospital of Marseille, Marseille, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Venton
authors.affiliation: 3Service d'hématologie, APHM, La Conception University Hospital of Marseille, Marseille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Colle
authors.affiliation: 3Service d'hématologie, APHM, La Conception University Hospital of Marseille, Marseille, France.|4SMARTc Unit, UMR S_911 CRO2, Aix Marseille University, Marseille, France.
authors.forename: Cedric
authors.initials: C
authors.lastname: Mercier
authors.affiliation: 4SMARTc Unit, UMR S_911 CRO2, Aix Marseille University, Marseille, France.
authors.forename: Raphaelle
authors.initials: R
authors.lastname: Fanciullino
authors.affiliation: 4SMARTc Unit, UMR S_911 CRO2, Aix Marseille University, Marseille, France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ciccolini
authors.affiliation: 3Service d'hématologie, APHM, La Conception University Hospital of Marseille, Marseille, France.
authors.forename: Vadim
authors.initials: V
authors.lastname: Ivanov
authors.affiliation: 5Laboratoire d'Hématologie, APHM, La Timone University Hospital of Marseille, Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Suchon
authors.affiliation: 3Service d'hématologie, APHM, La Conception University Hospital of Marseille, Marseille, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Sebahoun
authors.affiliation: 6Laboratoire de Biochimie et de Biologie Moléculaire, APHM, Nord University Hospital of Marseille, Marseille, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Beaufils
authors.affiliation: 6Laboratoire de Biochimie et de Biologie Moléculaire, APHM, Nord University Hospital of Marseille, Marseille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gabert
authors.affiliation: 7Hôpital Privé Beauregard, Marseille, France.
authors.forename: Djamal
authors.initials: D
authors.lastname: Hadjaj
authors.affiliation: 1UMR1090 TAGC, INSERM, Marseille, France.|2UMR1090 TAGC, Aix-Marseille Université, Marseille, France.|3Service d'hématologie, APHM, La Conception University Hospital of Marseille, Marseille, France.
authors.forename: Regis
authors.initials: R
authors.lastname: Costello
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000069439:Dasatinib / Q000494:pharmacology / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000187:drug effects / Q000235:genetics*; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011743:Pyrimidines / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; C498826:nilotinib; D000069439:Dasatinib
keywords: T315I; chronic myeloid leukemia; nilotinib; omacetaxine; ponatinib