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Imatinib mesylate‐sensitive blast crisis immediately after discontinuation of imatinib mesylate therapy in chronic myelogenous leukemia: Report of two cases
Author(s) -
Higashi Takehiro,
Tsukada Junichi,
Kato Chiaki,
Iwashige Atsushi,
Mizobe Takamitsu,
Machida Shinichiro,
Morimoto Hiroaki,
Ogawa Ryosuke,
Toda Yoko,
Tanaka Yoshiya
Publication year - 2004
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20096
Subject(s) - imatinib mesylate , discontinuation , medicine , imatinib , mesylate , chronic myelogenous leukemia , leukemia , pharmacology , myeloid leukemia , chemistry , organic chemistry
Although imatinib mesylate has shown encouraging activity in chronic myelogenous leukemia (CML), disease progression during therapy has been observed, manifested by clonal expansion of imatinib mesylate‐resistant leukemia cells. On the other hand, myelosuppression related to treatment of imatinib mesylate is often managed with temporary interruption of treatment or dose reduction. We here report two CML patients who had imatinib mesylate‐sensitive blast crisis (BC) immediately after discontinuation of imatinib mesylate therapy. The patients discontinued therapy because of neutropenia. Although there was no evidence of blastic phase during therapy, BC occurred 2 weeks after the withdrawal of treatment in both cases. Interestingly, additional chromosomal abnormalities were detected following the withdrawal of imatinib mesylate and disappeared by re‐introduction of this agent. The same doses of imatinib mesylate was still effective and remission was sustained with imatinib mesylate alone again. Our report suggests the possibility that withdrawal of imatinib mesylate may lead to proliferation of blast clones even in patients showing good responses to imatinib mesylate without signs of disease progression. Am. J. Hematol. 76:275–278, 2004. © 2004 Wiley‐Liss, Inc.