Document Detail


Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia.
MedLine Citation:
PMID:  12176876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Twenty-eight adults with chronic myelogenous leukemia (CML) that had relapsed after allogeneic stem cell transplantation (SCT) received imatinib mesylate (400-1000 mg/d). Disease was in chronic phase in 5 patients, accelerated in 15, and blastic in 8 (7 medullary, 1 extramedullary); median time from transplantation to relapse was 9 months (range, 1-137 months). Thirteen patients had undergone salvage donor lymphocyte infusion (DLI) (median time from DLI to imatinib mesylate therapy, 4 months [range, 2-39 months]). The overall response rate was 79% (22 of 28 patients); the complete hematologic response (CHR) rate was 74% (17 of 23 patients), and the cytogenetic response rate was 58% (15 of 26 patients; complete response in 9 [35%] patients). CHR rates were 100% for chronic phase, 83% for accelerated phase, and 43% for blastic phase. The patient with extramedullary blastic disease achieved complete response. Cytogenetic response rates were 63% (12 of 19 patients) for chronic or accelerated phases (complete cytogenetic response in 8) and 43% for blastic phase (3 of 7 patients). At median follow-up of 15 months, 19 patients were alive, 9 with no evidence of disease. The 1-year estimated survival rate was 74%. Five patients had recurrence of grade 3 (3 patients) or grades 1 to 2 (2 patients) graft-versus-host disease (GVHD). Severe granulocytopenia developed in 43% of patients and thrombocytopenia in 27%; both conditions reversed with dose adjustments of imatinib mesylate. We conclude that imatinib mesylate effectively controlled CML that recurred after allogeneic SCT, but it was associated with side effects including myelosuppression and recurrence of severe GVHD.
Authors:
Hagop M Kantarjian; Susan O'Brien; Jorge E Cortes; Sergio A Giralt; Mary Beth Rios; Jianqin Shan; Francis J Giles; Deborah A Thomas; Stefan Faderl; Marcos De Lima; Guillermo Garcia-Manero; Richard Champlin; Ralph Arlinghaus; Moshe Talpaz
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood     Volume:  100     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-14     Completed Date:  2002-09-13     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1590-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston 77030, USA. hkantarj@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Antineoplastic Agents / administration & dosage*
Combined Modality Therapy
Female
Hematopoietic Stem Cell Transplantation*
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality,  pathology,  therapy*
Male
Middle Aged
Piperazines / administration & dosage*
Protein-Tyrosine Kinases / antagonists & inhibitors
Pyrimidines / administration & dosage*
Recurrence
Survival Analysis
Transplantation, Homologous
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Piperazines; 0/Pyrimidines; 152459-95-5/imatinib; EC 2.7.10.1/Protein-Tyrosine Kinases
Comments/Corrections
Comment In:
Blood. 2003 Feb 1;101(3):1200-1   [PMID:  12529295 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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