| Chronic myeloid leukemia following therapy with imatinib mesylate (Gleevec). Bone marrow histopathology and correlation with genetic status. | |
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MedLine Citation:
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PMID: 12817431 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We evaluated bone marrow pathologic features and cytogenetic and molecular genetic status of 13 patients with interferon-resistant, chronic-phase chronic myeloid leukemia (CML), treated with imatinib mesylate (Gleevec). All had morphologic evidence of CML in the blood and bone marrow and were positive for bcr-abl by reverse transcriptase-polymerase chain reaction, fluorescence in situ hybridization (FISH), or both. Follow-up marrow biopsies, interphase FISH for bcr-abl, and conventional cytogenetics were performed at 3-month intervals (up to 24 months) after therapy initiation. All patients exhibited a reduction in bone marrow cellularity with decreases in myeloid/erythroid ratios at 3 to 6 months after therapy. The percentage of bcr-abl-positive cells by FISH decreased in all patients (pretherapy median, 73%; 3 months median, 47%). Cytogenetic and FISH data defined 2 groups after 6 months of follow-up: 5 patients became negative for bcr-abl by FISH; 8 remained positive, 4 of whom developed signs of clonal cytogenetic evolution. Patients who became negative for bcr-abl had no morphologic evidence of CML at 15 to 24 months of follow-up, whereas patients who remained positive redeveloped morphologic features of CML as cellularity increased. Some bcr-abl-positive patients showed signs of progression, including 2 patients who developed myeloid blast phase. Although all patients demonstrated an initial decrease in bone marrow cellularity after imatinib mesylate therapy, continued follow-up showed that histopathologic findings correlated with genetic response. |
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Authors:
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John L Frater; Martin S Tallman; Daina Variakojis; Brian J Druker; Debra Resta; Mary Beth Riley; Mary Ann Hrisinko; LoAnn C Peterson |
Publication Detail:
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Type: Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study |
Journal Detail:
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Title: American journal of clinical pathology Volume: 119 ISSN: 0002-9173 ISO Abbreviation: Am. J. Clin. Pathol. Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-23 Completed Date: 2003-07-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370470 Medline TA: Am J Clin Pathol Country: United States |
Other Details:
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Languages: eng Pagination: 833-41 Citation Subset: AIM; IM |
Affiliation:
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Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antineoplastic Agents
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therapeutic use* Biopsy Bone Marrow / pathology* Cytogenetic Analysis Drug Resistance Fibrosis Fusion Proteins, bcr-abl / genetics Histiocytes / pathology Humans Hyperplasia In Situ Hybridization, Fluorescence Interferons Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*, genetics*, pathology Leukocyte Count Megakaryocytes / pathology Piperazines / therapeutic use* Pyrimidines / therapeutic use* Reticulin / analysis Reverse Transcriptase Polymerase Chain Reaction |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Fusion Proteins, bcr-abl; 0/Piperazines; 0/Pyrimidines; 0/Reticulin; 152459-95-5/imatinib; 9008-11-1/Interferons |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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