Successful treatment using low-dose dasatinib for chronic myelogenous leukemia in a patient with megakaryoblastic transformation concomitant with myelofibrosis and an extramedullary tumor

Munemoto, Saori; Kasada, Atsuo; Murata, Ryoichi; Ueda, Mikio

doi:10.1016/j.leukres.2010.03.024

Cited by 4 publications

(4 citation statements)

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“…Identifying a resistant tumor source in them could direct salvage treatment. Relapse after transplant has a poor prognosis , and only 4 of 39 post‐transplant cases with follow‐up data in the current review obtained responses documented over 1 year. Seeking occult tumors before undertaking transplant would enable their eradication before conditioning and potentially improve prognosis.…”

Section: Discussionmentioning

confidence: 76%

“…They continued well at 1 and 2.5 years ; the former remission was documented by repeat scan at 1 year . The two others also achieved negative scans after second generation TKIs and were well at 3 and 10 months . Another case presented on TKI therapy with multiple bone involvement evident on PET/CT and similar fibrosis noted on histology, but no treatment details were given .…”

Section: Resultsmentioning

confidence: 98%

“…Scans were reported in four cases of CML with extramedullary blastic tumors. Two presented at 2 and 8 years after diagnosis with marrow disease controlled on imatinib mesylate and two at the time of first marrow diagnosis in chronic phase . Three involved single bones and one the mediastinum and lung.…”

Section: Resultsmentioning

confidence: 99%

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¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

Cunningham

Kohno

2016

American J Hematol

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Extramedullary tumors remain an obstacle to curing more acute leukemia patients. Their incidence is unknown because the presence of occult tumors that contribute to relapse is not routinely sought as in other cancers. No standard approach exists for treating tumors at most sites, apparent clinical response is typically followed by further tumors, and achievement of lengthy remission is uncommon. Body scanning with 18 FDG PET/CT now provides a means to identify the extent of occult tumors that enables directed tumor eradication and a way to evaluate tumor response. To evaluate its potential benefits, analysis was undertaken of 124 published cases scanned after apparent tumors were diagnosed. Clinical and radiologic exams underestimated extent of disease in over half of 100 cases. Among 70 cases that reported scans after various treatments, 70% achieved negative scans. Half relapsed subsequently but disease-free survivals up to 6 years were documented. These reported cases add to our knowledge of extramedullary leukemia in showing that further tumors are more likely than marrow relapse, clinical and radiologic evaluation of response is inadequate, intensive chemotherapy alone generally does not prevent progression and is associated with significant mortality, and tumor-directed plus systemic therapies appears the most effective approach, particularly to AML tumors. This analysis suggests this technology could increase our ability to eradicate all foci of leukemia, and identify tumors responsible for refractory, residual, and relapsed disease.

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Section: Discussionmentioning

confidence: 76%

Section: Resultsmentioning

confidence: 98%

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¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

Cunningham

Kohno

2016

American J Hematol

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“…In addition, Breccia et al 32 treated a 34-year-old Ph+ CML female patient who had a molecular relapse after haploidentical BMT with chronic liver GVHD and was severely intolerant to both imatinib and dasatinib at a standard dose; she had a CMR to dasatinib at a reduced dose of 20 mg/day without serious adverse events. A recent case report published by Yamaguchi et al 33 described a successful treatment of a 70-year-old man with CML who developed a megakaryoblastic crisis concomitant with myelofibrosis despite imatinib therapy with dasatinib at a starting dose of 80 mg/day.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Tolerability after Unusually Low Doses of Dasatinib in Chronic Myeloid Leukemia Patients Intolerant to Standard-Dose Dasatinib Therapy

Serpa

Sanabani

Bendit

et al. 2010

Clin Med Insights Oncol

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We report our experience in 4 patients with chronic myeloid leukemia (CML) who had discontinued imatinib as a result of adverse events and had switched to dasatinib. The chronic phase (n 2) and accelerated phase (n 2) CML patients received dasatinib at starting dose of 100 and 140 mg once daily, respectively. Reappearance of hematological toxicity was observed in 3 patients and pancreatitis in one patient. Treatment was given at a lower dose and patients were followed. The median follow-up was 13 months and the median dose of dasatinib until achievement of complete cytogenetic remission (CCyR) was 60 mg daily (range = 20 to 120 mg). All four patients had achieved CCyR at a median of 4 months (range = 3 to 5 months) and among them, three had also achieved major molecular remission. We conclude that low-dose dasatinib therapy in intolerant patients appears safe and efficacious and may be tried before drug discontinuation.

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Dasatinib

2021

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Successful treatment using low-dose dasatinib for chronic myelogenous leukemia in a patient with megakaryoblastic transformation concomitant with myelofibrosis and an extramedullary tumor

Cited by 4 publications

References 7 publications

¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

Efficacy and Tolerability after Unusually Low Doses of Dasatinib in Chronic Myeloid Leukemia Patients Intolerant to Standard-Dose Dasatinib Therapy

Dasatinib

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Successful treatment using low-dose dasatinib for chronic myelogenous leukemia in a patient with megakaryoblastic transformation concomitant with myelofibrosis and an extramedullary tumor

Cited by 4 publications

References 7 publications

18FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

18FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

Efficacy and Tolerability after Unusually Low Doses of Dasatinib in Chronic Myeloid Leukemia Patients Intolerant to Standard-Dose Dasatinib Therapy

Dasatinib

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¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases