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Imatinib is effective for prevention and improvement of fibrotic fasciitis as a manifestation of chronic GVHD

Bone Marrow Transplantation volume 47, pages 139–140 (2012)Cite this article

Fasciitis, which is characterized pathologically by thick fibrosis of the fascia, is a rare form of chronic GVHD and is often resistant to treatment and severely impairs quality of life.1 PDGF and transforming growth factor-β are crucial in the development of fibrosis. Imatinib strongly inhibits PDGF and transforming growth factor-β signalling through the blockade of the PDGF receptor and c-abl, respectively. Its inhibition of collagen synthesis in cultured fibroblasts and potent anti-fibrotic effects have been reported in both in vitro and in vivo studies.2, 3 Recently, imatinib has shown great promise for treating fibrotic disorders such as chronic GVHDs, including fasciitis.4, 5

We report the case of a 16-year-old male who was initially diagnosed with Ph-positive ALL at the age of 14 years. He presented with poor prognostic factors, including a WBC count of 390 × 109 per L at diagnosis, central nervous system leukaemia and poor response to steroid prophase. We treated him with 600 mg imatinib daily during induction chemotherapy, and he achieved complete haematological remission. Subsequently, we continued imatinib during three courses of consolidation therapy, but RT-PCR for minor BCR-ABL mRNA was never negative. Six months after diagnosis, he underwent BMT from an HLA-matched sibling donor. We continued imatinib until the start of myeloablative conditioning that consisted of CY, etoposide (VP)-16 and TBI 12 Gy. GVHD prophylaxis was provided by CsA and short MTX.

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References

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Authors and Affiliations

  1. Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan

    T Osumi, M Miharu, R Tanaka, T Takahashi & H Shimada

  2. Department of Pathology, Keio University School of Medicine, Tokyo, Japan

    W Du

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  1. T Osumi
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Correspondence to H Shimada.

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Osumi, T., Miharu, M., Tanaka, R. et al. Imatinib is effective for prevention and improvement of fibrotic fasciitis as a manifestation of chronic GVHD. Bone Marrow Transplant 47, 139–140 (2012). https://doi.org/10.1038/bmt.2011.10

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