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Blood, 1 April 2007, Vol. 109, No. 7, pp. 2791-2793.
Prepublished online as a Blood First Edition Paper on November 21, 2006; DOI 10.1182/blood-2006-04-019836.
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CLINICAL TRIALS AND OBSERVATIONS
Brief Report
Prophylactic administration of imatinib after hematopoietic cell transplantation for high-risk Philadelphia chromosomepositive leukemia
Paul A. Carpenter1,2,
David S. Snyder3,
Mary E. D. Flowers1,
Jean E. Sanders1,2,
Theodore A. Gooley1,
Paul J. Martin1,
Frederick R. Appelbaum1, and
Jerald P. Radich1
1 Clinical Research Division, Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA;
2 Departments of Pediatrics and Medicine, University of Washington, Seattle;
3 City of Hope Medical Center, Duarte, CA
Relapse occurs frequently after allogeneic hematopoietic cell transplantation (HCT) for treatment of high-risk Philadelphia chromosomepositive (Ph+) leukemia. Administration of imatinib early after HCT might provide an effective approach for preventing recurrent Ph+ leukemia, but the feasibility of this approach has not been systematically tested. Twenty-two patients, 15 with Ph+ acute lymphoblastic leukemia and 7 with high-risk chronic myelogenous leukemia, were enrolled in a prospective study and given imatinib from the time of engraftment until 365 days after HCT. Before day 90, adults (n = 19) tolerated a median average daily imatinib dose of 400 mg/d (range, 200-500 mg/d), and children (n = 3) tolerated 265 mg/m2/d (range, 200-290 mg/m2/d). The most common adverse events related to imatinib administration were grade 1-3 nausea, emesis, and serum transaminase elevations. We conclude that imatinib can be safely administered early after myeloablative allogeneic HCT at a dose intensity comparable to that used in primary therapy.

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