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Imatinib mesylate has limited activity against the central nervous system involvement of Philadelphia chromosome‐positive acute lymphoblastic leukaemia due to poor penetration into cerebrospinal fluid
Author(s) -
Takayama Nobuyuki,
Sato Norihide,
O'Brien Stephen G.,
Ikeda Yasuo,
Okamoto Shinichiro
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03881.x
Subject(s) - imatinib mesylate , imatinib , cerebrospinal fluid , medicine , bone marrow , philadelphia chromosome , central nervous system , tyrosine kinase inhibitor , acute lymphocytic leukemia , chemotherapy , pathology , leukemia , immunology , cancer research , lymphoblastic leukemia , biology , chromosomal translocation , biochemistry , myeloid leukemia , cancer , gene
Summary. A 32‐year‐old woman with relapsed Philadelphia chromosome‐positive acute lymphoblastic leukaemia was treated with imatinib mesylate (formerly STI571), a selective inhibitor of BCR/ABL tyrosine kinase. Although the initial marrow response was good and stably maintained, she subsequently relapsed with extensive infiltration of leukaemic cells into the central nervous system (CNS). After controlling her CNS disease with additional intrathecal chemotherapy, we measured the concentration of imatinib in cerebrospinal fluid (CSF) and blood simultaneously. The concentration of imatinib in CSF was about 92‐fold lower than that in blood. These results suggest that imatinib poorly penetrates the blood–brain barrier and has limited activity against CNS leukaemia.