Vol 8, Supp. B (2017)
Case report
Published online: 2017-12-21

open access

Page views 813
Article views/downloads 777
Get Citation

Connect on Social Media

Connect on Social Media

Skuteczność inhibitorów kinazy tyrozynowej po wieloletniej terapii cytoredukcyjnej w przebiegu przewlekłej białaczki szpikowej

Małgorzata Raźny1, Paweł Szwedyk1

Abstract

Przewlekła białaczka szpikowa (CML) do czasu wprowadzenia inhibitorów kinazy tyrozynowej (TKI) była schorzeniem nowotworowym o określonym czasie przeżycia wynoszącym w granicach 4‒5 lat; zaledwie 3% chorych uzyskiwało 10-letnie przeżycie. Wprowadzenie TKI pozwoliło radykalnie zmienić rokowanie w tym schorzeniu. W niniejszym artykule przedstawiono przypadek chorej z rozpoznaniem CML i blisko 20-letnią terapią, wyjściowo leczoną hydroksymocznikiem i busulfanem, a następnie TKI I i II generacji.

Article available in PDF format

View PDF (Polish) Download PDF file

References

  1. Druker BJ, Guilhot F, O'Brien SG, et al. IRIS Investigators. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med. 2006; 355(23): 2408–2417.
  2. O'Brien SG, Guilhot F, Larson RA, et al. IRIS Investigators. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2003; 348(11): 994–1004.
  3. Deininger M, O'Brien SG, Guilhot F, et al. International Randomized Study of Interferon Vs STI571 (IRIS) 8-year follow up: sustained survival and low risk for progression or events in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) treated with imatinib. Blood. 2009; 114: 1126.
  4. de Lavallade H, Apperley JF, Khorashad JS, et al. Imatinib for newly diagnosed patients with chronic myeloid leukemia: incidence of sustained responses in an intention-to-treat analysis. J Clin Oncol. 2008; 26(20): 3358–3363.
  5. Marin D, Bazeos A, Mahon FX, et al. Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. J Clin Oncol. 2010; 28(14): 2381–2388.
  6. Noens L, van Lierde MA, De Bock R, et al. Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study. Blood. 2009; 113(22): 5401–5411.
  7. Bixby D, Talpaz M. Mechanisms of resistance to tyrosine kinase inhibitors in chronic myeloid leukemia and recent therapeutic strategies to overcome resistance. Hematology Am Soc Hematol Educ Program. 2009: 461–476.
  8. Apperley JF, Apperley JF. Part I: mechanisms of resistance to imatinib in chronic myeloid leukaemia. Lancet Oncol. 2007; 8(11): 1018–1029.
  9. Thomas J, Wang L, Clark RE, et al. Active transport of imatinib into and out of cells: implications for drug resistance. Blood. 2004; 104(12): 3739–3745.
  10. Jordanides NE, Jorgensen HG, Holyoake TL, et al. Functional ABCG2 is overexpressed on primary CML CD34+ cells and is inhibited by imatinib mesylate. Blood. 2006; 108(4): 1370–1373.
  11. Hochhaus A, Baccarani M, Deininger M, et al. Dasatinib induces durable cytogenetic responses in patients with chronic myelogenous leukemia in chronic phase with resistance or intolerance to imatinib. Leukemia. 2008; 22(6): 1200–1206.
  12. Kantarjian H, Pasquini R, Hamerschlak N, et al. Dasatinib or high-dose imatinib for chronic-phase chronic myeloid leukemia after failure of first-line imatinib: a randomized phase 2 trial. Blood. 2007; 109(12): 5143–5150.
  13. Kantarjian H, Pasquini R, Lévy V, et al. Dasatinib or high-dose imatinib for chronic-phase chronic myeloid leukemia resistant to imatinib at a dose of 400 to 600 milligrams daily: two-year follow-up of a randomized phase 2 study (START-R). Cancer. 2009; 115(18): 4136–4147.
  14. le Coutre PD, Giles FJ, Hochhaus A. Nilotinib in patients with Ph+ chronic myeloid leukemia in accelerated phase following imatinib resistance or intolerance: 24-month follow-up results. Leukemia. 2012; 26(6): 1189–1194.
  15. Jabbour E, Kantarjian HM, Saglio G, et al. Early response with dasatinib or imatinib in chronic myeloid leukemia: 3-year follow-up from a randomized phase 3 trial (DASISION). Blood. 2014; 123(4): 494–500.
  16. Jabbour E, Kantarjian H, O'Brien S, et al. The achievement of an early complete cytogenetic response is a major determinant for outcome in patients with early chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors. Blood. 2011; 118(17): 4541–6; quiz 4759.



Hematology in Clinical Practice