Incidence and management of myelosuppression in patients with chronic-and accelerated-phase chronic myeloid leukemia treated with omacetaxine mepesuccinate

Luke Akard, Hagop M. Kantarjian, Franck E. Nicolini, Meir Wetzler, Jeffrey H. Lipton, Michele Baccarani, H. Jean Khoury, Sandra Kurtin, Elizabeth Li, Mihaela Munteanu, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

Omacetaxine mepesuccinate (Synribo®) is an inhibitor of protein synthesis indicated for the treatment of patients with chronic-or accelerated-phase chronic myeloid leukemia (CML) with resistance and/or intolerance to two or more tyrosine kinase inhibitors. Myelosuppression is the most common and clinically significant toxicity experienced by patients treated with omacetaxine. Here, we further examine the patterns of hematologic toxicity observed in clinical trials and describe the approach to management as well as resolution of events. Omacetaxine-related myelosuppression typically occurs more frequently during induction cycles. In general, the myelosuppression observed with omacetaxine treatment is manageable and reversible, and long-term administration is feasible. Careful monitoring, dose delays and reduction in administration days, and appropriate supportive care are critical for successful management of hematologic toxicity. Concerns regarDing myelosuppression, observed with many cancer treatments, should not prevent eligible patients from receiving omacetaxine, particularly CML patients with unsatisfactory responses to multiple lines of prior treatment.

Original languageEnglish (US)
Pages (from-to)654-665
Number of pages12
JournalLeukemia and Lymphoma
Volume57
Issue number3
DOIs
StatePublished - Mar 3 2016
Externally publishedYes

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Leukemia, Myeloid, Accelerated Phase
Leukemia, Myeloid, Chronic Phase
Incidence
Protein Synthesis Inhibitors
Therapeutics
Critical Care
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Protein-Tyrosine Kinases
Clinical Trials
homoharringtonine
Neoplasms

Keywords

  • Hematologic toxicity
  • Neutropenia
  • Omacetaxine mepesuccinate
  • Supportive care
  • Thrombocytopenia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Incidence and management of myelosuppression in patients with chronic-and accelerated-phase chronic myeloid leukemia treated with omacetaxine mepesuccinate. / Akard, Luke; Kantarjian, Hagop M.; Nicolini, Franck E.; Wetzler, Meir; Lipton, Jeffrey H.; Baccarani, Michele; Jean Khoury, H.; Kurtin, Sandra; Li, Elizabeth; Munteanu, Mihaela; Cortes, Jorge.

In: Leukemia and Lymphoma, Vol. 57, No. 3, 03.03.2016, p. 654-665.

Research output: Contribution to journalArticle

Akard, L, Kantarjian, HM, Nicolini, FE, Wetzler, M, Lipton, JH, Baccarani, M, Jean Khoury, H, Kurtin, S, Li, E, Munteanu, M & Cortes, J 2016, 'Incidence and management of myelosuppression in patients with chronic-and accelerated-phase chronic myeloid leukemia treated with omacetaxine mepesuccinate', Leukemia and Lymphoma, vol. 57, no. 3, pp. 654-665. https://doi.org/10.3109/10428194.2015.1071486
Akard, Luke ; Kantarjian, Hagop M. ; Nicolini, Franck E. ; Wetzler, Meir ; Lipton, Jeffrey H. ; Baccarani, Michele ; Jean Khoury, H. ; Kurtin, Sandra ; Li, Elizabeth ; Munteanu, Mihaela ; Cortes, Jorge. / Incidence and management of myelosuppression in patients with chronic-and accelerated-phase chronic myeloid leukemia treated with omacetaxine mepesuccinate. In: Leukemia and Lymphoma. 2016 ; Vol. 57, No. 3. pp. 654-665.
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