Deep molecular response after 3rd-line dasatinib treatment in patient with chronic myelogenous leukemia in chronic phase
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.
Keywords: chronic myelogenous leukemiadeep molecular responsedasatinib 3rd-line