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Achievement of complete donor-type chimerism and remission with dasatinib in Philadelphia chromosome-positive ALL relapsing after allogeneic transplantation

Bone Marrow Transplantation volume 45, pages 1125–1126 (2010)Cite this article

Approximately 20–30% of cases of adult ALL are Philadelphia chromosome positive (Ph+).1, 2 Owing to the dismal outcome of Ph+ ALL with chemotherapy, allogeneic hematopoietic SCT (HSCT) is routinely offered as it is considered to be the only potentially curative therapy.3 The usual therapeutic intervention in patients with ALL relapsing after allogeneic HSCT is donor lymphocyte infusion or a second allograft, but even with these treatments benefits to the patients are very limited.

The role of imatinib as the first molecularly targeted therapy to reduce relapse incidence after HSCT is significant, but a number of patients eventually relapse owing to the development of mutations in the ABL kinase domain that reduce sensitivity to imatinib.4 To override imatinib resistance and mutations, second-generation tyrosine kinase inhibitors such as dasatinib and AMN107 have been designed. These new compounds have shown promising clinical activity in imatinib-resistant patients with refractory Ph+ ALL and offer new treatment options for patients who do not achieve an optimal response to imatinib therapy.4 We report conversion to full donor-type chimerism and achievement of CR in a patient with Ph+ ALL relapsing after HSCT after dasatinib therapy.

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Authors and Affiliations

  1. Department of Hematology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

    M Conchon, I Bendit, M Serpa, P de Barros Ferreira, M M Y Novaes & P E Llacer-Dorliac

  2. Fundação Pro-Sangue, Hemocentro de São Paulo, São Paulo, Brazil

    S S Sanabani

  3. Department of Bone Marrow Transplantation, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

    U A Filho, R Saboya & F L Dulley

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  1. M Conchon
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  2. S S Sanabani
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  3. I Bendit
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  4. M Serpa
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  5. U A Filho
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  7. M M Y Novaes
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  8. R Saboya
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  9. P E Llacer-Dorliac
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  10. F L Dulley
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Correspondence to M Conchon.

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Conchon, M., Sanabani, S., Bendit, I. et al. Achievement of complete donor-type chimerism and remission with dasatinib in Philadelphia chromosome-positive ALL relapsing after allogeneic transplantation. Bone Marrow Transplant 45, 1125–1126 (2010). https://doi.org/10.1038/bmt.2009.310

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