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Successful treatment with imatinib-combined chemotherapy for relapsed Philadelphia-positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation.
Rinsho Ketsueki. 2009 Nov; 50(11):1612-5.RK

Abstract

The prognosis of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL) relapsing after allogeneic hematopoietic stem cell transplantation is dismal. Here we describe a patient with post-transplant relapse of Ph(+)ALL, who has remained in complete remission (CR) for 30 months after relapse. A 55-year-old woman with Ph(+)ALL received allo-HSCT from an unrelated donor during first CR. The conditioning regimen consisted of fludarabine+melphalan, and graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus and short-term methotrexate. She achieved and maintained molecular remission without developing GVHD after transplantation, but suffered a hematologic relapse on day 871. She received imatinib-combined chemotherapy, and again achieved molecular remission. Since the completion of imatinib-combined chemotherapy, she has been receiving imatinib monotherapy. Although it has been reported that chemotherapy and imatinib are effective only transiently in patients with relapsed Ph(+)ALL, our patient has remained in molecular remission for 30 months after post-transplant relapse at the time of this report. Our case suggests that by continuing imatinib after the induction of molecular remission by imatinib-combined chemotherapy, the antileukemic activity of imatinib could achieve durable remission in combination with the graft-versus-leukemia effect. However, this needs to be investigated in studies involving a large number of patients.

Authors+Show Affiliations

Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20009435

Citation

IMAHASHI, Nobuhiko, et al. "Successful Treatment With Imatinib-combined Chemotherapy for Relapsed Philadelphia-positive Acute Lymphoblastic Leukemia After Allogeneic Bone Marrow Transplantation." [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology, vol. 50, no. 11, 2009, pp. 1612-5.
IMAHASHI N, TOKUNAGA M, NISHIWAKI S, et al. Successful treatment with imatinib-combined chemotherapy for relapsed Philadelphia-positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation. Rinsho Ketsueki. 2009;50(11):1612-5.
IMAHASHI, N., TOKUNAGA, M., NISHIWAKI, S., YANAGISAWA, M., OZAWA, Y., & MIYAMURA, K. (2009). Successful treatment with imatinib-combined chemotherapy for relapsed Philadelphia-positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation. [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology, 50(11), 1612-5.
IMAHASHI N, et al. Successful Treatment With Imatinib-combined Chemotherapy for Relapsed Philadelphia-positive Acute Lymphoblastic Leukemia After Allogeneic Bone Marrow Transplantation. Rinsho Ketsueki. 2009;50(11):1612-5. PubMed PMID: 20009435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful treatment with imatinib-combined chemotherapy for relapsed Philadelphia-positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation. AU - IMAHASHI,Nobuhiko, AU - TOKUNAGA,Masahiro, AU - NISHIWAKI,Satoshi, AU - YANAGISAWA,Mayumi, AU - OZAWA,Yukiyasu, AU - MIYAMURA,Koichi, PY - 2009/12/17/entrez PY - 2009/12/17/pubmed PY - 2010/2/26/medline SP - 1612 EP - 5 JF - [Rinsho ketsueki] The Japanese journal of clinical hematology JO - Rinsho Ketsueki VL - 50 IS - 11 N2 - The prognosis of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL) relapsing after allogeneic hematopoietic stem cell transplantation is dismal. Here we describe a patient with post-transplant relapse of Ph(+)ALL, who has remained in complete remission (CR) for 30 months after relapse. A 55-year-old woman with Ph(+)ALL received allo-HSCT from an unrelated donor during first CR. The conditioning regimen consisted of fludarabine+melphalan, and graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus and short-term methotrexate. She achieved and maintained molecular remission without developing GVHD after transplantation, but suffered a hematologic relapse on day 871. She received imatinib-combined chemotherapy, and again achieved molecular remission. Since the completion of imatinib-combined chemotherapy, she has been receiving imatinib monotherapy. Although it has been reported that chemotherapy and imatinib are effective only transiently in patients with relapsed Ph(+)ALL, our patient has remained in molecular remission for 30 months after post-transplant relapse at the time of this report. Our case suggests that by continuing imatinib after the induction of molecular remission by imatinib-combined chemotherapy, the antileukemic activity of imatinib could achieve durable remission in combination with the graft-versus-leukemia effect. However, this needs to be investigated in studies involving a large number of patients. SN - 0485-1439 UR - https://www.unboundmedicine.com/medline/citation/20009435/Successful_treatment_with_imatinib_combined_chemotherapy_for_relapsed_Philadelphia_positive_acute_lymphoblastic_leukemia_after_allogeneic_bone_marrow_transplantation_ L2 - http://joi.jlc.jst.go.jp/JST.JSTAGE/rinketsu/50.1612?lang=en&from=PubMed DB - PRIME DP - Unbound Medicine ER -