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Blood, 15 May 2002, Vol. 99, No. 10, pp. 3861-3862
BRIEF REPORT
Imatinib mesylate (STI571) in the treatment of
relapse of chronic myeloid leukemia after allogeneic stem cell
transplantation
Eduardo Olavarria,
Charles Craddock,
Francesco Dazzi,
David Marin,
Sarah Marktel,
Jane F. Apperley, and
John M. Goldman
From the Haematology Department, Hammersmith Hospital,
London, England.
Donor lymphocyte infusion (DLI) can restore durable molecular
remission in a high percentage of patients with chronic myeloid leukemia (CML) who have relapses after allogeneic stem cell
transplantation, but for patients who do not respond survival is poor.
Imatinib mesylate (STI571) is a specific inhibitor of BCR-ABL
tyrosine kinase that can induce hematologic and cytogenetic remissions in patients with CML. We report here a male patient who had a relapse
to chronic phase after stem cell transplantation for CML, did not
benefit from treatment with DLI, and then was administered STI571 at a
dose of 400 mg daily. There was a rapid, complete hematologic response,
and complete restoration of donor-type hematopoiesis (100% 46, XX
marrow metaphases) was achieved after 6 months of therapy, though
RT-PCR studies still detected BCR-ABL transcripts in the blood at low
level. This case demonstrates that imatinib mesylate can be highly
effective in the management of patients who have relapses after
allograft for CML.
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