Document Detail


Novel tyrosine kinase inhibitor therapy before allogeneic stem cell transplantation in patients with chronic myeloid leukemia: no evidence for increased transplant-related toxicity.
MedLine Citation:
PMID:  17559140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML) are increasingly likely to have received a novel tyrosine kinase inhibitor (NTKI) after failing imatinib mesylate. It is unknown whether the use of these NTKIs before HSCT increases transplant-related toxicity.
METHODS: The outcome of 12 patients with CML (1 in chronic phase, 6 in the accelerated phase, and 5 in the blastic phase) who received dasatinib (n = 2), nilotinib (n = 7), or both (n = 3) before HSCT were retrospectively analyzed.
RESULTS: The median time on treatment was 134 days, and the median time from the end of NTKI therapy to HSCT was 34 days. The preparative regimen was ablative in 8 patients and nonablative in 4. All patients engrafted within 13 days. There was no significant early transplant-related toxicity. One patient developed secondary graft failure after 6 months from the first HSCT that required a second HSCT. Acute and chronic graft-versus-host disease (GVHD) was observed in 7 and 6 patients, respectively. Nine patients achieved a molecular response: 4 complete and 5 major (quantitative reverse transcriptase-polymerase chain reaction <0.05%). Three patients had disease progression by Day 30 after HSCT. Two patients developed disease recurrence after a median of 12 months. After a median follow-up of 10 months, 7 patients were alive in molecular response and 5 patients had died, 4 of disease progression and 1 of extensive chronic GVHD.
CONCLUSIONS: Previous treatment with NTKI did not increase transplant-related toxicity in this preliminary experience. Further follow-up and a larger number of patients will be necessary to confirm these observations.
Authors:
Elias Jabbour; Jorge Cortes; Hagop Kantarjian; Sergio Giralt; Borje S Andersson; Francis Giles; Elizabeth Shpall; Partow Kebriaei; Richard Champlin; Marcos de Lima
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  110     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-09     Completed Date:  2007-09-05     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  340-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Blood and Marrow Transplantation, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antineoplastic Agents / therapeutic use*
Combined Modality Therapy
Female
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy,  surgery,  therapy*
Male
Middle Aged
Protein Kinase Inhibitors / therapeutic use*
Protein-Tyrosine Kinases / antagonists & inhibitors*
Pyrimidines / therapeutic use*
Thiazoles / therapeutic use*
Chemical
Reg. No./Substance:
0/4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide; 0/Antineoplastic Agents; 0/Protein Kinase Inhibitors; 0/Pyrimidines; 0/Thiazoles; EC 2.7.10.1/Protein-Tyrosine Kinases; RBZ1571X5H/dasatinib

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