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Related Collections Neoplasia Brief Reports Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 May 2002, Vol. 99, No. 9, pp. 3472-3475 BRIEF REPORT High frequency of point mutations clustered within the adenosine triphosphate-binding region of BCR/ABL in patients with chronic myeloid leukemia or Ph-positive acute lymphoblastic leukemia who develop imatinib (STI571) resistance Susan Branford, Zbigniew Rudzki, Sonya Walsh, Andrew Grigg, Chris Arthur, Kerry Taylor, Richard Herrmann, Kevin P. Lynch, and Timothy P. Hughes From the Institute of Medical and Veterinary Science, Adelaide; Royal Melbourne Hospital; Royal North Shore Hospital, Sydney; Mater Hospital, Brisbane; Royal Perth Hospital; and Novartis Pharmaceuticals Australia, Sydney, Australia. Point mutations were found in the adenosine triphosphate (ATP) binding region of BCR/ABL in 12 of 18 patients with chronic myeloid leukemia (CML) or Ph-positive acute lymphoblastic leukemia (Ph+ ALL) and imatinib resistance (defined as loss of established hematologic response), but they were found in only 1 of 10 patients with CML with imatinib refractoriness (failure to achieve cytogenetic response). In 10 of 10 patients for whom samples were available, the mutation was not detected before the initiation of imatinib therapy. Three mutations (T315I, Y253H, and F317L present in 3, 1, and 1 patients, respectively) have a predicted role in abrogating imatinib binding to BCR/ABL, whereas 3 other mutations (E255K, G250E, and M351T, present in 4, 2, and 2 patients, respectively) do not. Thus we confirm a high frequency of mutations clustered within the ATP-binding region of BCR/ABL in resistant patients. Screening may allow intervention before relapse by identifying emerging mutations with defined impacts on imatinib binding. Certain mutations may respond to higher doses of imatinib, whereas other mutations may mandate switching to another therapeutic strategy. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: Leukoencephalopathy and papovavirus infection after treatment with chemotherapy and anti-CD20 monoclonal antibody Paola Matteucci, Michele Magni, Massimo Di Nicola, Carmelo Carlo-Stella, Caterina Uberti, and Alessandro M. Gianni Blood 2002 100: 1104-1105. [Full Text] [PDF] This article has been cited by other articles: M. Versele, W. Talloen, C. Rockx, T. Geerts, B. Janssen, T. Lavrijssen, P. King, H. W.H. Gohlmann, M. Page, and T. 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