Durable molecular response to imatinib mesylate following nonmyeloablative allogeneic stem-cell transplantation for persisting myeloid blast crisis in chronic myeloid leukemia

Haematologica. 2003 Aug;88(8):ECR29.

Abstract

We report a chronic myeloid leukemia (CML) patient in chronic phase (CP) who developed blast crisis (BC) under imatinib mesylate administered in a dose reduced and non-continuous fashion because of hematologic intolerance. The patient underwent nonmyeloablative stem-cell transplant from a matched unrelated donor, but failed to achieve full donor chimerism and antileukemic response resulting in persistence of advanced disease. Complete hematologic, cytogenetic and molecular responses were attained 5 weeks after readministration of regularly dosed imatinib and two-step nested RT-PCR confirmed molecular remission throughout a 6 month follow-up period. This is the first case demonstrating that imatinib mesylate is a highly effective and safe treatment option to induce durable molecular remission in patients with CML who remain in myeloid blast crisis after nonmyeloablative allogeneic stem-cell transplantation.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Benzamides
  • Blast Crisis / drug therapy
  • Blast Crisis / therapy*
  • Female
  • Hematopoietic Stem Cell Transplantation* / methods
  • Hematopoietic Stem Cells / drug effects*
  • Humans
  • Imatinib Mesylate
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Middle Aged
  • Myeloablative Agonists / therapeutic use*
  • Piperazines / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Transplantation, Homologous

Substances

  • Antineoplastic Agents
  • Benzamides
  • Myeloablative Agonists
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate