Document Detail


Rapid and sustained increase of large granular lymphocytes and rare cytomegalovirus reactivation during dasatinib treatment in chronic myelogenous leukemia patients.
MedLine Citation:
PMID:  22767140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively investigated increases in large granular lymphocytes (LGL) in peripheral blood during dasatinib treatment in 25 chronic myelogenous leukemia patients. Fifteen of 25 patients (60 %) showed an increase in LGL. All 15 of these patients also showed an increase in NK cells, and 11 showed an increase in CD8(+) T cells. High frequencies of clonal rearrangements of TCR-β, -γ, and -δ genes were observed in LGL (+) patients, and at lower frequencies in LGL (-) patients as well. Clinical responses were favorable for all. With respect to their newly obtained complete molecular response after dasatinib treatment, LGL (+) patients showed higher response rates than did LGL (-) patients. In contrast, pleural effusions were more commonly observed in LGL (+) patients (60 %) than in LGL (-) patients (20 %). LGL counts significantly increased at 2 h after oral intake of dasatinib in all 25 patients. This was not observed in treatment with imatinib or nilotinib. Cytomegalovirus (CMV) C7-HRP tests were negative in all patients. Serum CMV-IgM antibodies were positive in only 2 of 25 patients without symptom of infection. Thus, LGL lymphocytosis during dasatinib treatment may be correlated with favorable molecular response, and with increased incidence of pleural effusions. In the clinical setting, CMV reactivation appears uncommon.
Authors:
Hideo Tanaka; Shizuka Nakashima; Miyuki Usuda
Publication Detail:
Type:  Journal Article     Date:  2012-07-06
Journal Detail:
Title:  International journal of hematology     Volume:  96     ISSN:  1865-3774     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-17     Completed Date:  2013-02-06     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  308-19     Citation Subset:  IM    
Affiliation:
Department of Hematology, Hiroshima City Asa Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima 731-0293, Japan. hd-tanaka@asa-hosp.city.hiroshima.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents / administration & dosage,  adverse effects,  therapeutic use
Cytomegalovirus / immunology*
Female
Gene Rearrangement, T-Lymphocyte
Humans
Immunophenotyping
Immunosuppressive Agents / administration & dosage,  adverse effects*,  therapeutic use
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy,  immunology*,  virology*
Leukocytes, Mononuclear / immunology,  metabolism
Lymphocyte Count
Lymphocytes / immunology*,  metabolism,  pathology
Male
Middle Aged
Pleural Effusion, Malignant / etiology
Protein Kinase Inhibitors / administration & dosage,  adverse effects,  therapeutic use
Pyrimidines / administration & dosage,  adverse effects*,  therapeutic use
Receptors, Antigen, T-Cell / genetics
Thiazoles / administration & dosage,  adverse effects*,  therapeutic use
Treatment Outcome
Virus Activation / immunology*
Young Adult
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Immunosuppressive Agents; 0/Protein Kinase Inhibitors; 0/Pyrimidines; 0/Receptors, Antigen, T-Cell; 0/Thiazoles; RBZ1571X5H/dasatinib

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