[Treatment-free molecular remission achieved by combination therapy with imatinib and IFNα in CML with BIM deletion polymorphism relapsed after stop imatinib]

Rinsho Ketsueki. 2015 Feb;56(2):216-9. doi: 10.11406/rinketsu.56.216.
[Article in Japanese]

Abstract

A 51-year-old man with chronic myeloid leukemia (CML) was treated with imatinib (IM). After 24 months of treatment, he achieved a complete molecular response (CMR), which he sustained for 3 years. However, 4 months after discontinuing IM treatment, the CML relapsed. The patient was treated again with IM and achieved CMR. A combination of IM and interferon-α (IFNα) was administered for the following year, and then discontinued. The patient has since sustained CMR without therapy for 24 months, to date. This patient was found to have a BCL2L11 (BIM) deletion polymorphism. CML patients with a BIM deletion polymorphism show a low response to IM, and we infer that the BIM deletion polymorphism is a negative factor for discontinuation of IM. IFNα treatment is expected to prevent relapse during immunological surveillance. Therefore, the combination of IM and IFNα might be a feasible approach for CML patients who experience difficulty with IM discontinuation.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Apoptosis Regulatory Proteins / genetics*
  • Bcl-2-Like Protein 11
  • Benzamides / administration & dosage
  • Combined Modality Therapy
  • Gene Deletion
  • Humans
  • Imatinib Mesylate
  • Interferon-alpha / administration & dosage
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Male
  • Membrane Proteins / genetics*
  • Middle Aged
  • Piperazines / administration & dosage
  • Polymorphism, Genetic*
  • Proto-Oncogene Proteins / genetics*
  • Pyrimidines / administration & dosage
  • Recurrence
  • Remission Induction / methods

Substances

  • Apoptosis Regulatory Proteins
  • BCL2L11 protein, human
  • Bcl-2-Like Protein 11
  • Benzamides
  • Interferon-alpha
  • Membrane Proteins
  • Piperazines
  • Proto-Oncogene Proteins
  • Pyrimidines
  • Imatinib Mesylate