[Efficacy of imatinib mesylate, a specific inhibitor of BCR/ABL tyrosine kinase, on chronic myeloid leukemia in blast phase].

Abstract

BACKGROUND & OBJECTIVE:

Chronic myeloid leukemia (CML) in blast phase is refractory with a poor prognosis. This study was to evaluate efficacy of imatinib mesylate, a specific inhibitor of BCR/ABL tyrosine kinase, on CML in blast phase.

METHODS:

Nineteen patients with CML in blast phase (imatinib treatment group) received induction of cytarabine-based standard chemotherapy for 2 cycles, and 400 mg/d of imatinib mesylate for 4 weeks. Patients with no remission received 600 mg/d of imatinib mesylate for another 8 weeks. Treatment of 600 mg/d of imatinib mesylate was maintained if it showed effects after 8 weeks, otherwise it would be stopped. Twenty-two patients with CML in blast phase (historical control group) received inducement of cytarabine-based chemotherapy for 2 cycles, and other regimens of consolidation or continuous induction.

RESULTS:

Sixteen patients of imatinib treatment group achieved no hematologic remission after induction. After treated with imatinib mesylate, 6 of 16 (38%) achieved hematologic complete remission (CHR), and major cytogenetic response; 2 of 16(13%) achieved hematologic partial remission (PHR); 1 of 16 (6%) returned to chronic phase with minor cytogenetic response. Total hematologic response rate of imatinib treatment group was 57%; 1-year survival rate was 38% (6/16). Eighteen patients of historical control group achieved no hematologic remission after inducement. After treated with other regimens, 2 (11%) achieved CHR, and 1 (6%) achieved PHR. Total hematologic response rate of historical control group was 17%; 1-year survival rate was 6%(1/18), significantly lower than that of imatinib treatment group (P< 0.05).

CONCLUSIONS:

Imatinib mesylate may have anti-leukemic activity, and prolong survival time of patients with CML in blast phase. But problems of tumor relapse, and drug resistance are still present.

• Authors: Guo-Cai Zhang, Dong Zheng, Qun-Hua Li, Xiao-Hu Li, Cheng-Cai Cai, Shao-Kai Luo, Juan Li, Ai-Hua Peng, Xiu-Zhen Tong, En-Xun Tan, Wen-De Hong
• Journal: Ai zheng = Aizheng = Chinese journal of cancer (Ai Zheng) Vol. 23 Issue 12 Pg. 1696-9 (Dec 2004) China
• PMID: 15601563 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antineoplastic Agents
• Benzamides
• Piperazines
• Pyrimidines
• Imatinib Mesylate
• Protein-Tyrosine Kinases
• Fusion Proteins, bcr-abl

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (pharmacology, therapeutic use)
• Benzamides
• Blast Crisis (drug therapy)
• Drug Resistance, Neoplasm
• Female
• Fusion Proteins, bcr-abl
• Humans
• Imatinib Mesylate
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, pathology)
• Male
• Middle Aged
• Piperazines (pharmacology, therapeutic use)
• Protein-Tyrosine Kinases (antagonists & inhibitors)
• Pyrimidines (pharmacology, therapeutic use)
• Recurrence
• Remission Induction
• Survival Rate