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Imatinib mesylate induces durable complete remission of advanced CML persisting after allogeneic bone marrow transplantation

Leukemia volume 17, pages 458–460 (2003)Cite this article

TO THE EDITOR

The development of imatinib mesylate (STI-571; Glivec; Gleevec; Novartis, Basel, Switzerland), a rationally designed inhibitor of the bcr-abl protein tyrosine kinase, has marked the beginning of a new era in the treatment of CML. In first chronic phase, imatinib mesylate yields complete hematological remission rates of 98% and an unprecedented 60% rate of major or complete cytogenetic responses.1 CML in myeloid blast crisis responds substantially less well with only 8% complete hematological and 7% complete cytogenetic responses, and a high frequency of early relapses.2 As it stands today, allogeneic stem cell transplantation remains the only established curative treatment for CML, with a 10-year disease-free survival of approximately 50% for patients in early first chronic phase and with a matched sibling donor. Allotransplanted patients with a molecular, cytogenetic or hematological relapse can often be successfully rescued by discontinuation of immunosuppressive therapy and/or infusion of donor lymphocytes (DLI).3 Little is known on the place of imatinib mesylate in the management of disease persistence or relapse after allogeneic stem cell transplantation for CML. Here we report a case of advanced CML that persisted after a failed unrelated bone marrow transplantation. Under treatment with imatinib mesylate, stable complete donor chimerism in the peripheral blood, improved graft function and a complete molecular response were achieved.

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Acknowledgements

PV is a Clinical Investigator of Fonds voor Wetenschappelijk Onderzoek Vlaanderen. ER is aspirant of Fonds voor Wetenschappelijk Onderzoek Vlaanderen. The assistance of the technical staff of the Leukemia Cytogenetics Laboratory, of Hilde Vranckx and Frans Houtmeyers is gratefully acknowledged. This text presents research results of the Belgian Programme of Interuniversity Poles of Attraction initiated by the Belgian State, Prime Minister’s Office, Science Policy Programming. The scientific responsibility is assumed by the authors.

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Authors and Affiliations

  1. Department of Human Genetics, KU Leuven, Leuven, Belgium

    P Vandenberghe & A Hagemeijer

  2. Laboratory of Experimental Hematology, KU Leuven, Leuven, Belgium

    P Vandenberghe & E Ronsyn

  3. Department of Laboratory Medicine, KU Leuven, Leuven, Belgium

    N Boeckx

  4. Laboratorium voor Forensische Genetica en Moleculaire Archeologie, KU Leuven, Leuven, Belgium

    R Decorte

  5. Department of Haematology, University Hospital Leuven, KU Leuven, Leuven, Belgium

    G Verhoef

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  1. P Vandenberghe
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Vandenberghe, P., Boeckx, N., Ronsyn, E. et al. Imatinib mesylate induces durable complete remission of advanced CML persisting after allogeneic bone marrow transplantation. Leukemia 17, 458–460 (2003). https://doi.org/10.1038/sj.leu.2402811

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