Successful treatment with dasatinib of 18-years-old patient with chronic myelogenous leukemia who relapsed after the 1st-line therapy with imatinib

Abstract

Children and adolescents rarely suffer from chronic myelogenous leukaemia (CML). Nonetheless, we assert that those aged below 18 years with this disease should be treated as adults, especially that in some countries (including Poland), official regulations still forbid treating such patients with 2^nd generation tyrosine kinase inhibitors (TKI). To support this view, we present a case study of a 16-year-old female patient with CML in whom initial treatment with imatinib had proved unsuccessful. She was thus prevented from receiving 2^nd generation TKI and also allogeneic haematopoietic stem cell transplantation was impossible, as a donor could not be found. Imatinib treatment was therefore continued at a higher dose, despite its poor tolerance. Thirteen months after diagnosis, the patient attained adulthood and thence an adult programme of dasatinib, treatment was initiated. After 3 months, complete cytogenic and major molecular remission was achieved and after 9 months this state of affairs has been maintained.