Submitted April 26, 2006
Accepted November 13, 2006
Prophylactic administration of imatinib after hematopoietic cell transplantation for high-risk Philadelphia chromosome-positive leukemia
Paul A. Carpenter*, David S. Snyder, Mary E.D. Flowers, Jean E. Sanders, Theodore A. Gooley, Paul J. Martin, Frederick R. Appelbaum, and Jerald P. Radich
Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA
City of Hope National Medical Center, Duarte, CA
Depts of Pediatrics & Medicine, University of Washington, Seattle, WA
* Corresponding author; email: pcarpent{at}fhcrc.org.
Relapse occurs frequently after allogeneic hematopoietic cell transplantation (HCT) for treatment of high-risk Philadelphia chromosome-positive (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/day (range, 200 to 500 mg/day), and children (n=3) tolerated 265 mg/m2/day (range, 200 to 290 mg/m2). 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.
