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Hematologic and cytogenetic remission by STI571 (Glivec) in a patient relapsing with accelerated phase CML after second allogeneic stem cell transplantation

Abstract

We describe the clinical activity of the ABL kinase inhibitor STI571 in a patient with accelerated phase of chronic myeloid leukemia (CML) relapsing after a second allogeneic BMT and with minimal levels of donor chimerism. STI571 resulted in rapid elimination of leukemic cells with ensuing prolonged severe leukopenia and neutropenia complicated by neutropenic fever and colitis. Subsequent hematopoietic recovery was driven by donor derived cells and was associated with grade 3 graft-versus-host disease (GVHD). STI571 induced sustained hematological and cytogenetic remission combined with controllable GvHD, therapeutic goals not achieved by two preceding allogeneic transplants and repeated donor lymphocyte transfusions (DLT). Bone Marrow Transplantation (2001) 28, 721–724.

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References

  1. Goldman JM . Chronic myeloid leukemia Curr Opin Hematol 1997 4: 277–285

    Article  CAS  PubMed  Google Scholar 

  2. Kolb HJ, Holler E . Adoptive immunotherapy with donor lymphocyte transfusions Curr Opin Oncol 1997 9: 139–145

    Article  CAS  PubMed  Google Scholar 

  3. Kolb HJ, Schattenberg A, Goldman JM et al. Graft-versus-leukemia effect of donor lymphocyte transfusions in marrow grafted patients. European Group for Blood and Marrow Transplantation Working Party Chronic Leukemia Blood 1995 86: 2041–2050

    CAS  PubMed  Google Scholar 

  4. Dazzi F, Szydlo RM, Goldman JM . Donor lymphocyte infusions for relapse of chronic myeloid leukemia after allogeneic stem cell transplant: where we now stand Exp Hematol 1999 27: 1477–1486

    Article  CAS  PubMed  Google Scholar 

  5. Elmaagacli AH, Beelen DW, Schaefer UW . A retrospective single centre study of the outcome of five different therapy approaches in 48 patients with relapse of chronic myelogenous leukemia after allogeneic bone marrow transplantation Bone Marrow Transplant 1997 20: 1045–1055

    Article  CAS  PubMed  Google Scholar 

  6. Carlens S, Remberger M, Aschan J, Ringden O . The role of disease stage in the response to donor lymphocyte infusions as treatment for leukemic relapse Biol Blood Marrow Transplant 2001 7: 31–38

    Article  CAS  PubMed  Google Scholar 

  7. Collins RHJ, Shpilberg O, Drobyski WR et al. Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation J Clin Oncol 1997 15: 433–444

    Article  PubMed  Google Scholar 

  8. Arcese W, Goldman JM, D'Arcangelo E et al. Outcome for patients who relapse after allogeneic bone marrow transplantation for chronic myeloid leukemia. Chronic Leukemia Working Party. European Bone Marrow Transplantation Group Blood 1993 82: 3211–3219

    CAS  PubMed  Google Scholar 

  9. Druker BJ, Talpaz M, Resta DJ et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia New Engl J Med 2001 344: 1031–1037

    Article  CAS  PubMed  Google Scholar 

  10. Druker BJ, Sawyers CL, Kantarjian H et al. Activity of a specific inhibitor of the BCR-ABL tyrosine kinase in the blast crisis of chronic myeloid leukemia and acute lymphoblastic leukemia with the Philadelphia chromosome New Engl J Med 2001 344: 1038–1042

    Article  CAS  PubMed  Google Scholar 

  11. Kolb HJ . Donor leukocyte transfusions for treatment of leukemic relapse after bone marrow transplantation. EBMT Immunology and Chronic Leukemia Working Parties Vox Sang 1998 74 (Suppl. 2): 321–329

    Article  Google Scholar 

  12. Goldman JM, Szydlo R, Horowitz MM et al. Choice of pretransplant treatment and timing of transplants for chronic myelogenous leukemia in chronic phase Blood 1993 82: 2235–2238

    CAS  PubMed  Google Scholar 

  13. Gratwohl A, Hermans J . Allogeneic bone marrow transplantation for chronic myeloid leukemia. Working Party Chronic Leukemia of the European Group for Blood and Marrow Transplantation (EBMT) Bone Marrow Transplant 1996 17: (Suppl. 3) S7–S9

    PubMed  Google Scholar 

  14. Sausville EA . A Bcr/Abl kinase antagonist for chronic myelogenous leukemia: a promising path for progress emerges J Natl Cancer Inst 1999 91: 102–103

    Article  CAS  PubMed  Google Scholar 

  15. Ottmann OG, Sawyers CL, Druker BJ et al. A phase II study to determine the safety and antileukemic effects of STI571 in adult patients with Philadelphia chromosome positive acute leukemias Blood 2000 96: 828a (Abstr.)

    Google Scholar 

  16. Talpaz M, Sawyers CL, Kantarjian H et al. Activity of an abl specific tyrosine kinase inhibitor in patients with bcr-abl positive acute leukemias, including chronic myelogenous leukemia in blast crisis Proc Am Soc Clin Oncol 2000 19: 4a (Abstr.)

    Google Scholar 

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Acknowledgements

We are indebted to Frau Kilb for donor chimerism analyses and to S Kriener MD for the pathological review of marrow histologies.

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Wassmann, B., Klein, S., Scheuring, U. et al. Hematologic and cytogenetic remission by STI571 (Glivec) in a patient relapsing with accelerated phase CML after second allogeneic stem cell transplantation. Bone Marrow Transplant 28, 721–724 (2001). https://doi.org/10.1038/sj.bmt.1703222

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