[Sustained remission with allogeneic peripheral blood stem cell transplantation and subsequent maintenance therapy with dasatinib in a patient with myeloblastic crisis of imatinib-resistant CML]

Rinsho Ketsueki. 2013 Mar;54(3):279-83.
[Article in Japanese]

Abstract

A 45-year-old man with chronic myelogenous leukemia (CML) in the chronic phase was treated with imatinib mesylate (IM). Although partial cytogenetic response (CyR) was obtained in 3 months, the patient exhibited back pain after treatment with IM for 5 months. He was diagnosed with myeloblastic crisis of CML with 30% blasts in the bone marrow. An extramedullary tumor with a diameter of 5-cm was found adjacent to the pancreatic head. Mutation analysis of the bcr/abl chimeric gene was negative. After the treatment with dasatinib (140 mg/day) for 40 days, complete CyR was obtained by bone marrow examination and the extramedullary tumor shrunk resulting in partial response on computed tomography. Allogeneic peripheral blood stem cell transplantation (allo-PBSCT) was performed from his HLA-DR one locus-mismatched sister. He has been in molecular remission for 24 months after allo-PBSCT and maintenance therapy with dasatinib has been administered. Dasatinib was tolerable without severe adverse events before and after allo-PBSCT in this case.

Publication types

  • Case Reports

MeSH terms

  • Benzamides / therapeutic use
  • Dasatinib
  • Drug Resistance, Neoplasm*
  • Humans
  • Imatinib Mesylate
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation* / methods
  • Piperazines / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Remission Induction / methods
  • Thiazoles / therapeutic use*
  • Transplantation, Homologous / methods
  • Treatment Outcome

Substances

  • Benzamides
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Thiazoles
  • Imatinib Mesylate
  • Dasatinib