Dynamics and management of cytopenias associated with dasatinib therapy in patients with chronic myeloid leukemia in chronic phase after imatinib failure

Alfonso Quintás-Cardama, Fabio Pires De Souza Santos, Hagop Kantarjian, Susan O'Brien, Stefan Faderl, Ahmed Awais, Gautam Borthakur, Jorge Cortes

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

BACKGROUND: The incidence, dynamics, and management of cytopenias were investigated in patients with chronic myeloid leukemia in chronic phase (CP CML) who received dasatinib therapy after imatinib failure. METHODS: Data were analyzed from 130 patients with CP CML who were treated with dasatinib from November 2003 to March 2006 in phase 1 (n = 22) or phase 2 or 3 (n = 108) studies for the development of grade 2 to 4 cytopenia (according to the National Cancer Institute Common Terminology Criteria [version 3.0]). RESULTS: Grade 2 to 4 neutropenia and/or thrombocytopenia occurred in 94 (72%) patients during dasatinib therapy and grade 3 to 4 occurred in 67 (52%) patients. Of the 94 patients who developed grade 2 to 4 neutropenia and/or thrombocytopenia, 64 (68%) also developed at least grade 2 anemia, and 16 (17%) developed grade 3 to 4 anemia. Management of cytopenias included transient dasatinib interruption in 35 (37%) patients, filgrastim in 12 (14%) patients, recombinant erythropoietin in 29 (45%) patients, and interleukin-11 in 3 (5%) patients. Factors associated with an increased risk for developing grade 2 to 4 cytopenias were longer time from diagnosis to treatment, prior interferon or imatinib therapy, and a lower white blood cell count at the initiation of dasatinib therapy. CONCLUSIONS: Hematologic toxicity was frequent during dasatinib therapy in patients with CP CML, particularly at doses >100 mg daily. Treatment interruption and/or dose reduction as well as growth factor support were found to be safe and efficacious strategies to facilitate the continuous administration of dasatinib.

Original languageEnglish (US)
Pages (from-to)3935-3943
Number of pages9
JournalCancer
Volume115
Issue number17
DOIs
StatePublished - Sep 1 2009
Externally publishedYes

Keywords

  • Chronic myeloid leukemia
  • Chronic phase
  • Cytopenias
  • Dasatinib
  • Imatinib
  • Toxicity
  • Treatment interruption

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Quintás-Cardama, A., Santos, F. P. D. S., Kantarjian, H., O'Brien, S., Faderl, S., Awais, A., Borthakur, G., & Cortes, J. (2009). Dynamics and management of cytopenias associated with dasatinib therapy in patients with chronic myeloid leukemia in chronic phase after imatinib failure. Cancer, 115(17), 3935-3943. https://doi.org/10.1002/cncr.24432