A lower dosage of imatinib is sufficient to maintain undetectable disease in patients with chronic myeloid leukemia with long-term low-grade toxicity of the treatment

被引：17

作者：

Faber, Edgar ^{[1
]}

Divoka, Martina ^{[1
]}

Skoumalova, Ivana ^{[1
]}

Novak, Martin ^{[1
]}

Maresova, Ivana ^{[1
]}

Micova, Katerina ^{[2
,3
]}

Friedecky, David ^{[2
,3
]}

Adam, Tomas ^{[2
,3
]}

Jarosova, Marie ^{[1
]}

Indrak, Karel ^{[1
]}

机构：

[1] Palacky Univ, Univ Hosp, Dept Hematooncol, CZ-77520 Olomouc, Czech Republic

[2] Palacky Univ, Univ Hosp, Lab Inherited Metab Disorders, CZ-77520 Olomouc, Czech Republic

[3] Palacky Univ, Fac Med & Dent, CZ-77520 Olomouc, Czech Republic

来源：

LEUKEMIA & LYMPHOMA | 2016年 / 57卷 / 02期

关键词：

Chronic myeloid leukemia; imatinib; minimal residual disease; side effects; COMPLETE MOLECULAR REMISSION; CML PATIENTS; THERAPY; DISCONTINUATION; MANAGEMENT;

D O I：

10.3109/10428194.2015.1056184

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The information about chronic myeloid leukemia (CML) patients with a deep molecular response of >= 4.5 log reduction (MR4.5) in whom the dose of imatinib (IM) had to be reduced to relieve toxicity is insufficient. In 205 CML patients the dose of IM was reduced in 19 (31.2%) out of 61 patients with MR4.5. The patients (12 pretreated with interferon-alpha) achieved MR4.5 after an average of 27.7 months. The duration of MR4.5 before the reduction of the dose was 16-123 (mean = 56.7) months. After the IM reduction (200 mg daily to 400 mg twice weekly for 15-90 (mean = 48) months) MR4.5 or major molecular response (MMR) was maintained in 14 (73.7%) and 2 (10.5%) patients, respectively. Three patients who lost MMR (15.8%) after the discontinuation of IM regained MR4.5 after the reintroduction of a lower dose. A lower dosage of IM should be tested for the management of side effects in patients with MR4.5 in prospective studies.

引用

页码：370 / 375

页数：6

共 16 条

[1] Dose Interruption/Reduction Of Tyrosine Kinase Inhibitors In The First 3 Months Of Treatment of CML Is Associated With Inferior Early Molecular Responses and Predicts For Increased Likelihood Of Discontinuation Of The 1st Line Agent [J].

Apperley, Jane F. ;

Szydlo, Richard M. ;

Gerrard, Gareth ;

McCue, James R. ;

Wardle, Jamie ;

Clark, Richard E. ;

O'Brien, Stephen G. ;

Foroni, Letizia .

BLOOD, 2013, 122 (21)

[2] European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013 [J].

Baccarani, Michele ;

Deininger, Michael W. ;

Rosti, Gianantonio ;

Hochhaus, Andreas ;

Soverini, Simona ;

Apperley, Jane F. ;

Cervantes, Francisco ;

Clark, Richard E. ;

Cortes, Jorge E. ;

Guilhot, Francois ;

Hjorth-Hansen, Henrik ;

Hughes, Timothy P. ;

Kantarjian, Hagop M. ;

Kim, Dong-Wook ;

Larson, Richard A. ;

Lipton, Jeffrey H. ;

Mahon, Francois-Xavier ;

Martinelli, Giovanni ;

Mayer, Jiri ;

Mueller, Martin C. ;

Niederwieser, Dietger ;

Pane, Fabrizio ;

Radich, Jerald P. ;

Rousselot, Philippe ;

Saglio, Giuseppe ;

Saussele, Susanne ;

Schiffer, Charles ;

Silver, Richard ;

Simonsson, Bengt ;

Steegmann, Juan-Luis ;

Goldman, John M. ;

Hehlmann, Ruediger .

BLOOD, 2013, 122 (06) :872-884

[3] Occurrence and current management of side effects in chronic myeloid leukemia patients treated frontline with tyrosine kinase inhibitors [J].

Breccia, Massimo ;

Alimena, Giuliana .

LEUKEMIA RESEARCH, 2013, 37 (06) :713-720

[4]

Burdova K, 2013, CLIN THERAP S, V35, pe18

[5] Intermittent dosage of imatinib mesylate in CML patients with a history of significant hematologic toxicity after standard dosing [J].

Faber, Edgar ;

Nausova, Jitka ;

Jarosova, Marie ;

Egorin, Merrill J. ;

Holzerová, Milena ;

Rozmanova, Sarka ;

Maresova, Ivana ;

Divoky, Vladimir ;

Indrak, Karel .

LEUKEMIA & LYMPHOMA, 2006, 47 (06) :1082-1090

[6] Interferon-alpha in chronic myeloid leukemia revisited: A long-term retrospective study in Central and Northern Moravia [J].

Faber, Edgar ;

Kuba, Adam ;

Zapletalova, Jana ;

Divoka, Martina ;

Rohon, Peter ;

Holzerova, Milena ;

Jarosova, Marie ;

Indrak, Karel .

BIOMEDICAL PAPERS-OLOMOUC, 2013, 157 (03) :248-256

[7] Imatinib trough plasma levels do not correlate with the response to therapy in patients with chronic myeloid leukemia in routine clinical setting [J].

Faber, Edgar ;

Friedecky, David ;

Micova, Katerina ;

Rozmanova, Sarka ;

Divoka, Martina ;

Jarosova, Marie ;

Indrak, Karel ;

Adam, Tomas .

ANNALS OF HEMATOLOGY, 2012, 91 (06) :923-929

[8] Has the time come for induction and maintenance imatinib therapy in chronic myeloid leukemia? [J].

Faber, Edgar .

LEUKEMIA RESEARCH, 2009, 33 (05) :605-606

[9] Discontinuation of imatinib in patients with chronic myeloid leukaemia who have maintained complete molecular remission for at least 2 years: the prospective, multicentre Stop Imatinib (STIM) trial [J].

Mahon, Francois-Xavier ;

Rea, Delphine ;

Guilhot, Joelle ;

Guilhot, Francois ;

Huguet, Francoise ;

Nicolini, Franck ;

Legros, Laurence ;

Charbonnier, Aude ;

Guerci, Agnes ;

Varet, Bruno ;

Etienne, Gabriel ;

Reiffers, Josy ;

Rousselot, Philippe .

LANCET ONCOLOGY, 2010, 11 (11) :1029-1035

[10] Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study [J].

Noens, Lucien ;

van Lierde, Marie-Anne ;

De Bock, Robrecht ;

Verhoef, Gregor ;

Zachee, Pierre ;

Berneman, Zwi ;

Martiat, Philippe ;

Mineur, Philippe ;

Van Eygen, Koen ;

MacDonald, Karen ;

De Geest, Sabina ;

Albrecht, Tara ;

Abraham, Ivo .

BLOOD, 2009, 113 (22) :5401-5411

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