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Erschienen in: International Journal of Hematology 6/2018

29.11.2017 | Case Report

10-year complete remission in a Philadelphia chromosome-positive acute lymphoblastic leukemia patient using imatinib without high-intensity chemotherapy or allogeneic stem cell transplantation

verfasst von: Katsumichi Fujimaki, Yukako Hattori, Hideaki Nakajima

Erschienen in: International Journal of Hematology | Ausgabe 6/2018

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Abstract

The outcome of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL) has improved with the use of tyrosine kinase inhibitors, such as imatinib and dasatinib. We report a 63-year-old woman with Ph-ALL who maintained complete remission for 10 years using imatinib without high-intensity chemotherapy or allogeneic stem cell transplantation. She underwent induction therapy with imatinib plus prednisolone and achieved complete remission by day 53. Imatinib was continued until 103 months, when it was stopped in response to renal dysfunction; however, the patient continued to exhibit molecular remission at 120 months. This is the first report in the literature describing a patient with Ph-ALL who achieved remission for more than 10 years after treatment only with imatinib.
Literatur
1.
Zurück zum Zitat Secker-Walker LM, Craig JM, Hawkins JM, Hoffbrand AV. Philadelphia positive acute lymphoblastic leukemia in adults: age distribution, BCR breakpoint and prognostic significance. Leukemia. 1991;5:196–9.PubMed Secker-Walker LM, Craig JM, Hawkins JM, Hoffbrand AV. Philadelphia positive acute lymphoblastic leukemia in adults: age distribution, BCR breakpoint and prognostic significance. Leukemia. 1991;5:196–9.PubMed
2.
Zurück zum Zitat Burmeister T, Schwartz S, Bartram CR, Gokbuget N, Hoelzer D, Thiel E. Patients’ age and BCR-ABL frequency in adult B-precursor ALL: a retrospective analysis from the GMALL study group. Blood. 2008;112:918–9.CrossRefPubMed Burmeister T, Schwartz S, Bartram CR, Gokbuget N, Hoelzer D, Thiel E. Patients’ age and BCR-ABL frequency in adult B-precursor ALL: a retrospective analysis from the GMALL study group. Blood. 2008;112:918–9.CrossRefPubMed
3.
Zurück zum Zitat Larson RA. Management of acute lymphoblastic leukemia in older patients. Semin Hematol. 2006;43:126–33.CrossRefPubMed Larson RA. Management of acute lymphoblastic leukemia in older patients. Semin Hematol. 2006;43:126–33.CrossRefPubMed
4.
Zurück zum Zitat Chiaretti S, Vitale A, Cazzaniga G, Orlando SM, Silvestri D, Fazi P, et al. Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts. Haematologica. 2013;98:1702–10.CrossRefPubMedPubMedCentral Chiaretti S, Vitale A, Cazzaniga G, Orlando SM, Silvestri D, Fazi P, et al. Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts. Haematologica. 2013;98:1702–10.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Yanada M, Takeuchi J, Sugiura I, Akiyama H, Usui N, Yagasaki F, et al. High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR-ABL—positive acute lymphoblastic leukemia: a Phase II Study by the Japan Adult Leukemia Study Group. J Clin Oncol. 2006;24:460–6.CrossRefPubMed Yanada M, Takeuchi J, Sugiura I, Akiyama H, Usui N, Yagasaki F, et al. High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR-ABL—positive acute lymphoblastic leukemia: a Phase II Study by the Japan Adult Leukemia Study Group. J Clin Oncol. 2006;24:460–6.CrossRefPubMed
6.
Zurück zum Zitat Fujisawa S, Mizuta S, Akiyama H, Ueda Y, Aoyama Y, Hatta Y, et al. Phase II study of imatinib-based chemotherapy for newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia. Am J Hematol. 2017;92:367–74.CrossRefPubMed Fujisawa S, Mizuta S, Akiyama H, Ueda Y, Aoyama Y, Hatta Y, et al. Phase II study of imatinib-based chemotherapy for newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia. Am J Hematol. 2017;92:367–74.CrossRefPubMed
7.
Zurück zum Zitat Daver N, Thomas D, Ravandi F, Cortes J, Garris R, Jabbour E, et al. Final report of a phase II study of imatinib mesylate with hyper-CVAD for the front-line treatment of adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Haematologica. 2015;100:653–61.CrossRefPubMedPubMedCentral Daver N, Thomas D, Ravandi F, Cortes J, Garris R, Jabbour E, et al. Final report of a phase II study of imatinib mesylate with hyper-CVAD for the front-line treatment of adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Haematologica. 2015;100:653–61.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Ravandi F, O’Brien SM, Cortes JE, Thomas DM, Garris R, Faderl S, et al. Long-term follow-up of a phase 2 study of chemotherapy plus dasatinib for the initial treatment of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Cancer. 2015;121:4158–64.CrossRefPubMedPubMedCentral Ravandi F, O’Brien SM, Cortes JE, Thomas DM, Garris R, Faderl S, et al. Long-term follow-up of a phase 2 study of chemotherapy plus dasatinib for the initial treatment of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Cancer. 2015;121:4158–64.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Vignetti M, Fazi P, Cimino G, Martinelli G, Di Raimondo F, Ferrara F, et al. Imatinib plus steroids induces complete remissions and prolonged survival in elderly Philadelphia chromosome-positive patients with acute lymphoblastic leukemia without additional chemotherapy: results of the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) LAL0201-B protocol. Blood. 2007;109:3676–8.CrossRefPubMed Vignetti M, Fazi P, Cimino G, Martinelli G, Di Raimondo F, Ferrara F, et al. Imatinib plus steroids induces complete remissions and prolonged survival in elderly Philadelphia chromosome-positive patients with acute lymphoblastic leukemia without additional chemotherapy: results of the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) LAL0201-B protocol. Blood. 2007;109:3676–8.CrossRefPubMed
10.
Zurück zum Zitat Foà R, Vitale A, Vignetti M, Meloni G, Guarini A, De Propris MS, et al. Dasatinib as first-line treatment for adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood. 2011;118:6521–8.CrossRefPubMed Foà R, Vitale A, Vignetti M, Meloni G, Guarini A, De Propris MS, et al. Dasatinib as first-line treatment for adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood. 2011;118:6521–8.CrossRefPubMed
11.
Zurück zum Zitat Takeuchi J, Kusumoto S, Akiyama H, Kanda Y, Izutsu K. JSH guideline for tumors of hematopoietic and lymphoid tissues-leukemia: 3. Acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL). Int J Hematol. 2017;106:732–7.CrossRefPubMed Takeuchi J, Kusumoto S, Akiyama H, Kanda Y, Izutsu K. JSH guideline for tumors of hematopoietic and lymphoid tissues-leukemia: 3. Acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL). Int J Hematol. 2017;106:732–7.CrossRefPubMed
12.
Zurück zum Zitat Sabina C, Antonella V, Loredana E, Anna LF, Silvana A, Alfonso P, et al. Multicenter total therapy GIMEMA LAL 1509 protocol for de novo adult Ph+ acute lymphoblastic leukemia (ALL) patients. Updated results and refined genetic-based prognostic stratification. Blood. 2015;126:81. Sabina C, Antonella V, Loredana E, Anna LF, Silvana A, Alfonso P, et al. Multicenter total therapy GIMEMA LAL 1509 protocol for de novo adult Ph+ acute lymphoblastic leukemia (ALL) patients. Updated results and refined genetic-based prognostic stratification. Blood. 2015;126:81.
Metadaten
Titel
10-year complete remission in a Philadelphia chromosome-positive acute lymphoblastic leukemia patient using imatinib without high-intensity chemotherapy or allogeneic stem cell transplantation
verfasst von
Katsumichi Fujimaki
Yukako Hattori
Hideaki Nakajima
Publikationsdatum
29.11.2017
Verlag
Springer Japan
Erschienen in
International Journal of Hematology / Ausgabe 6/2018
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-017-2382-2

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