Vol 6, No 2 (2015)
Case report
Published online: 2015-08-07

open access

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Deep molecular response after 3rd-line dasatinib treatment in patient with chronic myelogenous leukemia in chronic phase

Maria Lewandowska, Michał Gniot, Błażej Ratajczak, Małgorzata Jarmuż-Szymczak, Krzysztof Lewandowski
DOI: 10.5603/Hem.2015.0031
Hematologia 2015;6(2):213-217.

Abstract

Imatinib (IM) therapy failure in patients with chronic myelogenous leukemia (CML) in the chronic phase is an indication for second-line treatment with second generation of tyrosine kinase inhibitors (2nd generation of TKI). Unfortunately, the symptoms of therapy intolerance/failure are observed in part of them. We present a case of CML patient in chronic phase with IM-resistance in whom hematologic toxicity was observed during nilotinib treatment (thrombocytopenia grade 3 acc. CTCAE), as well as the symptoms of mutational TKI-resistance (H396P KD BCR-ABL) thereafter. On the basis of 2nd generation of TKI efficacy in vitro profile, a decision about dasatinib therapy in a dose of 100 mg orally daily was undertaken. Complete cytogenetic response was obtained after 6 months, and major molecular response after 9 months of therapy. A follow-up revealed continuous improvement in quality of molecular response. In June 2014 deep molecular response was obtained. Moreover, their persistence during consecutive months was also confirmed.




Hematology in Clinical Practice