title: Incidence and management of myelosuppression in patients with chronic- and accelerated-phase chronic myeloid leukemia treated with omacetaxine mepesuccinate.
abstract: Omacetaxine mepesuccinate (Synribo) is an inhibitor of protein synthesis indicated for the treatment of patients with chronic- or accelerated-phase chronic myeloid leukemia (CML) with resistance and/or intolerance to two or more tyrosine kinase inhibitors. Myelosuppression is the most common and clinically significant toxicity experienced by patients treated with omacetaxine. Here, we further examine the patterns of hematologic toxicity observed in clinical trials and describe the approach to management as well as resolution of events. Omacetaxine-related myelosuppression typically occurs more frequently during induction cycles. In general, the myelosuppression observed with omacetaxine treatment is manageable and reversible, and long-term administration is feasible. Careful monitoring, dose delays and reduction in administration days, and appropriate supportive care are critical for successful management of hematologic toxicity. Concerns regarding myelosuppression, observed with many cancer treatments, should not prevent eligible patients from receiving omacetaxine, particularly CML patients with unsatisfactory responses to multiple lines of prior treatment.
authors.affiliation: a Indiana Blood and Marrow Transplantation St. Francis Franciscan Alliance , Indianapolis , IN , USA .
authors.forename: Luke
authors.initials: L
authors.lastname: Akard
authors.affiliation: b The University of Texas MD Anderson Cancer Center , Houston , TX , USA .
authors.forename: Hagop M
authors.initials: HM
authors.lastname: Kantarjian
authors.affiliation: c Centre Hospitalier Lyon Sud, Pierre Bénite, and INSERM U1052, Centre de Recherche contre le Cancer de Lyon , Lyon , France .
authors.forename: Franck E
authors.initials: FE
authors.lastname: Nicolini
authors.affiliation: d Roswell Park Cancer Institute , Buffalo , NY , USA .
authors.forename: Meir
authors.initials: M
authors.lastname: Wetzler
authors.affiliation: e Princess Margaret Cancer Centre , Toronto , Ontario , Canada .
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Lipton
authors.affiliation: f University of Bologna , Bologna , Italy .
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
authors.affiliation: g Emory University School of Medicine , Atlanta , GA , USA .
authors.forename: H
authors.initials: H
authors.lastname: Jean Khoury
authors.affiliation: h University of Arizona Cancer Center , Tucson , AZ , USA .
authors.forename: Sandra
authors.initials: S
authors.lastname: Kurtin
authors.affiliation: i PharmaStat LLC , Newark , CA , USA , and.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Li
authors.affiliation: j Teva Branded Pharmaceutical Products R&D , Frazer , PA , USA.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Munteanu
authors.affiliation: b The University of Texas MD Anderson Cancer Center , Houston , TX , USA .
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion; D019468:Disease Management; D005260:Female; D006248:Harringtonines / Q000009:adverse effects* / Q000627:therapeutic use; D000077863:Homoharringtonine; D006801:Humans; D015994:Incidence; D015465:Leukemia, Myeloid, Accelerated Phase / Q000150:complications* / Q000188:drug therapy; D015466:Leukemia, Myeloid, Chronic-Phase / Q000150:complications* / Q000188:drug therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D006248:Harringtonines; D000077863:Homoharringtonine
keywords: Hematologic toxicity; neutropenia; omacetaxine mepesuccinate; supportive care; thrombocytopenia