Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia

Hagop M. Kantarjian, Susan O'Brien, Jorge E. Cortes, Sergio A. Giralt, Mary Beth Rios, Jianqin Shan, Francis J. Giles, Deborah A. Thomas, Stefan Faderl, Marcos De Lima, Guillermo Garcia-Manero, Richard Champlin, Ralph Arlinghaus, Moshe Talpaz

Research output: Contribution to journalArticle

Abstract

Twenty-eight adults with chronic myelogenous leukemia (CML) that had relapsed after allogeneic stem cell transplantation (SCT) received imatinib mesylate (400-1000 mg/d). Disease was in chronic phase in 5 patients, accelerated in 15, and blastic in 8 (7 medullary, 1 extramedullary); median time from transplantation to relapse was 9 months (range, 1-137 months). Thirteen patients had undergone salvage donor lymphocyte infusion (DLI) (median time from DLI to imatinib mesylate therapy, 4 months [range, 2-39 months]). The overall response rate was 79% (22 of 28 patients); the complete hematologic response (CHR) rate was 74% (17 of 23 patients), and the cytogenetic response rate was 58% (15 of 26 patients; complete response in 9 [35%] patients). CHR rates were 100% for chronic phase, 83% for accelerated phase, and 43% for blastic phase. The patient with extramedullary blastic disease achieved complete response. Cytogenetic response rates were 63% (12 of 19 patients) for chronic or accelerated phases (complete cytogenetic response in 8) and 43% for blastic phase (3 of 7 patients). At median follow-up of 15 months, 19 patients were alive, 9 with no evidence of disease. The 1-year estimated survival rate was 74%. Five patients had recurrence of grade 3 (3 patients) or grades 1 to 2 (2 patients) graft-versus-host disease (GVHD). Severe granulocytopenia developed in 43% of patients and thrombocytopenia in 27%; both conditions reversed with dose adjustments of imatinib mesylate. We conclude that imatinib mesylate effectively controlled CML that recurred after allogeneic SCT, but it was associated with side effects including myelosuppression and recurrence of severe GVHD.

Original languageEnglish (US)
Pages (from-to)1590-1595
Number of pages6
JournalBlood
Volume100
Issue number5
StatePublished - Sep 1 2002
Externally publishedYes

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Stem Cell Transplantation
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Stem cells
Recurrence
Lymphocytes
Grafts
Therapeutics
Salvaging
Cytogenetics
Graft vs Host Disease
Imatinib Mesylate
Tissue Donors
Agranulocytosis
Thrombocytopenia
Survival Rate
Transplantation

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Kantarjian, H. M., O'Brien, S., Cortes, J. E., Giralt, S. A., Rios, M. B., Shan, J., ... Talpaz, M. (2002). Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia. Blood, 100(5), 1590-1595.

Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia. / Kantarjian, Hagop M.; O'Brien, Susan; Cortes, Jorge E.; Giralt, Sergio A.; Rios, Mary Beth; Shan, Jianqin; Giles, Francis J.; Thomas, Deborah A.; Faderl, Stefan; De Lima, Marcos; Garcia-Manero, Guillermo; Champlin, Richard; Arlinghaus, Ralph; Talpaz, Moshe.

In: Blood, Vol. 100, No. 5, 01.09.2002, p. 1590-1595.

Research output: Contribution to journalArticle

Kantarjian, HM, O'Brien, S, Cortes, JE, Giralt, SA, Rios, MB, Shan, J, Giles, FJ, Thomas, DA, Faderl, S, De Lima, M, Garcia-Manero, G, Champlin, R, Arlinghaus, R & Talpaz, M 2002, 'Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia', Blood, vol. 100, no. 5, pp. 1590-1595.
Kantarjian HM, O'Brien S, Cortes JE, Giralt SA, Rios MB, Shan J et al. Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia. Blood. 2002 Sep 1;100(5):1590-1595.
Kantarjian, Hagop M. ; O'Brien, Susan ; Cortes, Jorge E. ; Giralt, Sergio A. ; Rios, Mary Beth ; Shan, Jianqin ; Giles, Francis J. ; Thomas, Deborah A. ; Faderl, Stefan ; De Lima, Marcos ; Garcia-Manero, Guillermo ; Champlin, Richard ; Arlinghaus, Ralph ; Talpaz, Moshe. / Imatinib mesylate therapy for relapse after allogeneic stem cell transplantation for chronic myelogenous leukemia. In: Blood. 2002 ; Vol. 100, No. 5. pp. 1590-1595.
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abstract = "Twenty-eight adults with chronic myelogenous leukemia (CML) that had relapsed after allogeneic stem cell transplantation (SCT) received imatinib mesylate (400-1000 mg/d). Disease was in chronic phase in 5 patients, accelerated in 15, and blastic in 8 (7 medullary, 1 extramedullary); median time from transplantation to relapse was 9 months (range, 1-137 months). Thirteen patients had undergone salvage donor lymphocyte infusion (DLI) (median time from DLI to imatinib mesylate therapy, 4 months [range, 2-39 months]). The overall response rate was 79{\%} (22 of 28 patients); the complete hematologic response (CHR) rate was 74{\%} (17 of 23 patients), and the cytogenetic response rate was 58{\%} (15 of 26 patients; complete response in 9 [35{\%}] patients). CHR rates were 100{\%} for chronic phase, 83{\%} for accelerated phase, and 43{\%} for blastic phase. The patient with extramedullary blastic disease achieved complete response. Cytogenetic response rates were 63{\%} (12 of 19 patients) for chronic or accelerated phases (complete cytogenetic response in 8) and 43{\%} for blastic phase (3 of 7 patients). At median follow-up of 15 months, 19 patients were alive, 9 with no evidence of disease. The 1-year estimated survival rate was 74{\%}. Five patients had recurrence of grade 3 (3 patients) or grades 1 to 2 (2 patients) graft-versus-host disease (GVHD). Severe granulocytopenia developed in 43{\%} of patients and thrombocytopenia in 27{\%}; both conditions reversed with dose adjustments of imatinib mesylate. We conclude that imatinib mesylate effectively controlled CML that recurred after allogeneic SCT, but it was associated with side effects including myelosuppression and recurrence of severe GVHD.",
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AU - Rios, Mary Beth

AU - Shan, Jianqin

AU - Giles, Francis J.

AU - Thomas, Deborah A.

AU - Faderl, Stefan

AU - De Lima, Marcos

AU - Garcia-Manero, Guillermo

AU - Champlin, Richard

AU - Arlinghaus, Ralph

AU - Talpaz, Moshe

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N2 - Twenty-eight adults with chronic myelogenous leukemia (CML) that had relapsed after allogeneic stem cell transplantation (SCT) received imatinib mesylate (400-1000 mg/d). Disease was in chronic phase in 5 patients, accelerated in 15, and blastic in 8 (7 medullary, 1 extramedullary); median time from transplantation to relapse was 9 months (range, 1-137 months). Thirteen patients had undergone salvage donor lymphocyte infusion (DLI) (median time from DLI to imatinib mesylate therapy, 4 months [range, 2-39 months]). The overall response rate was 79% (22 of 28 patients); the complete hematologic response (CHR) rate was 74% (17 of 23 patients), and the cytogenetic response rate was 58% (15 of 26 patients; complete response in 9 [35%] patients). CHR rates were 100% for chronic phase, 83% for accelerated phase, and 43% for blastic phase. The patient with extramedullary blastic disease achieved complete response. Cytogenetic response rates were 63% (12 of 19 patients) for chronic or accelerated phases (complete cytogenetic response in 8) and 43% for blastic phase (3 of 7 patients). At median follow-up of 15 months, 19 patients were alive, 9 with no evidence of disease. The 1-year estimated survival rate was 74%. Five patients had recurrence of grade 3 (3 patients) or grades 1 to 2 (2 patients) graft-versus-host disease (GVHD). Severe granulocytopenia developed in 43% of patients and thrombocytopenia in 27%; both conditions reversed with dose adjustments of imatinib mesylate. We conclude that imatinib mesylate effectively controlled CML that recurred after allogeneic SCT, but it was associated with side effects including myelosuppression and recurrence of severe GVHD.

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