Discontinuation of imatinib therapy after achievement of complete molecular response in a Ph(+) CML patient treated while in long lasting complete cytogenetic remission (CCR) induced by interferon

Leuk Res. 2006 Dec;30(12):1577-9. doi: 10.1016/j.leukres.2006.03.011. Epub 2006 Apr 19.

Abstract

Imatinib has become the gold standard therapy for Ph(+) CML, as it induces complete cytogenetic remission (CCR) in 75-90% of patients in chronic phase (CP), and up to 40% of these patients obtain at least a 3 log reduction of BCR/ABL transcript [Kantarjian HM, Cortes JE, O'Brien S, Luthra R, Giles F, Verstovsek S, et al. Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-alpha. Blood. 2004;104:1979-1988]. However, it is not yet stated whether continued therapy is required to maintain this response or whether imatinib may be discontinued after confirmation of a prolonged complete molecular remission (CMR). We here report on a Ph(+) CML case in long lasting CCR following interferon-alpha treatment (IFN) which reached CMR with imatinib but soon relapsed at molecular level after this latter drug discontinuation; we considered the present observation also in the light of previously reported data.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / therapy*
  • Benzamides
  • Cytogenetic Analysis / methods*
  • Follow-Up Studies
  • Fusion Proteins, bcr-abl / genetics
  • Gene Expression Profiling
  • Gene Expression Regulation, Leukemic
  • Humans
  • Imatinib Mesylate
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / diagnosis
  • Neoplasms, Second Primary / therapy*
  • Piperazines
  • Pyrimidines
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / therapy*
  • Recurrence
  • Remission Induction
  • Reverse Transcriptase Polymerase Chain Reaction
  • Transcription, Genetic
  • Treatment Outcome

Substances

  • Benzamides
  • Interferon-alpha
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate
  • Fusion Proteins, bcr-abl