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Related Collections Neoplasia Clinical Trials and Observations Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 July 2002, Vol. 100, No. 2, pp. 435-441 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Hematopathologic and cytogenetic findings in imatinib mesylate-treated chronic myelogenous leukemia patients: 14 months' experience Rita M. Braziel, Teresa M. Launder, Brian J. Druker, Susan B. Olson, R. Ellen Magenis, Michael J. Mauro, Charles L. Sawyers, Ronald L. Paquette, and Michael E. O'Dwyer From the Oregon Health Sciences University, Portland; and the University of California at Los Angeles. Imatinib mesylate, an Abl kinase inhibitor, produces sustained complete hematologic responses (CHRs) in chronic myelogenous leukemia (CML) patients, but the sequence and timing of morphologic and cytogenetic changes in CML patients during prolonged imatinib mesylate treatment has not been described. In this report, we document sequential hematologic and bone marrow findings in 19 interferon-refractory/interferon-intolerant chronic phase CML patients on imatinib mesylate for at least 14 months. Patients treated at an effective oral dose (300 to 600 mg per day) were followed with peripheral blood (PB) counts, marrow examination, and cytogenetic studies at 0, 2, 5, 8, 11, and 14 months. By 2 months, 17 of 19 patients achieved CHR; 1 reached CHR by 5 months, and 1 at 11 months. Five of 19 patients developed cytopenias requiring treatment interruption and/or dose reduction, but all were able to continue in CHR on study. In contrast to interferon-alfa treatment, imatinib mesylate-treated CML patients achieved not only CHR but complete morphologic marrow response. Normalization of marrow lagged behind PB response; however, by 8 months, all marrows showed normal or reduced cellularity without morphologic evidence of CML. Eighteen of 19 patients continued in CHR and morphologic marrow remission at 14 months; 1 patient relapsed with chronic phase CML. Although hematologic and marrow responses were uniform, cytogenetic responses were variable. Complete cytogenetic responses occurred in 6 patients, with 4 also in remission by fluorescent in situ hybridization and/or reverse-transcription-polymerase chain reaction. Six of 19 had partial and 7 of 19 no cytogenetic response. Several patients acquired additional clonal cytogenetic abnormalities during therapy, a finding with significant implications for prognosis and laboratory monitoring in imatinib mesylate-treated CML patients. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: Myelodysplastic subclones in chronic myeloid leukemia: implications for imatinib mesylate therapy Stuart L. Goldberg, Ravi A. Madan, Scott D. Rowley, Andrew L. Pecora, Jack W. Hsu, and Ramana Tantravahi Blood 2003 101: 781. [Full Text] [PDF] This article has been cited by other articles: A. Fabarius, M. Giehl, B. Rebacz, A. Kramer, O. Frank, C. Haferlach, P. Duesberg, R. Hehlmann, W. Seifarth, and A. Hochhaus Centrosome aberrations and G1 phase arrest after in vitro and in vivo treatment with the SRC/ABL inhibitor dasatinib Haematologica, August 1, 2008; 93(8): 1145 - 1154. [Abstract] [Full Text] [PDF] C. Kovitz, H. 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Nakahata A novel mechanism for imatinib mesylate-induced cell death of BCR-ABL-positive human leukemic cells: caspase-independent, necrosis-like programmed cell death mediated by serine protease activity Blood, March 15, 2004; 103(6): 2299 - 2307. [Abstract] [Full Text] [PDF] J. H. Antin A 41-Year-Old Woman With Chronic Myelogenous Leukemia JAMA, August 27, 2003; 290(8): 1083 - 1090. [Full Text] [PDF] M. W.N. Deininger, S. G. O'Brien, J. M. Ford, and B. J. Druker Practical Management of Patients With Chronic Myeloid Leukemia Receiving Imatinib J. Clin. Oncol., April 15, 2003; 21(8): 1637 - 1647. [Abstract] [Full Text] [PDF] S. L. Goldberg, R. A. Madan, S. D. Rowley, A. L. Pecora, J. W. Hsu, and R. Tantravahi Myelodysplastic subclones in chronic myeloid leukemia: implications for imatinib mesylate therapy Blood, January 15, 2003; 101(2): 781 - 781. [Full Text] [PDF]

	Copyright © 2002 by American Society of Hematology         Online ISSN: 1528-0020