Early switch to nilotinib in a case of non-optimal response to imatinib
We report a case of excellent response to nilotinib in a 22 years old man with chronic myeloid leukemia in suboptimal response to imatinib. After diagnosis he started cytoreductive therapy with cytarabine and hydroxyurea, then he begun therapy with imatinib 400 mg/day. After 3 months of treatment, h...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SEEd
2015-10-01
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| Series: | Clinical Management Issues |
| Subjects: | |
| Online Access: | https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/1135 |
| _version_ | 1828794899557777408 |
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| author | Alessandra Iurlo Tommaso Radice Chiara De Philippis Manuela Zappa Mauro Pomati Agostino Cortelezzi |
| author_facet | Alessandra Iurlo Tommaso Radice Chiara De Philippis Manuela Zappa Mauro Pomati Agostino Cortelezzi |
| author_sort | Alessandra Iurlo |
| collection | DOAJ |
| description | We report a case of excellent response to nilotinib in a 22 years old man with chronic myeloid leukemia in suboptimal response to imatinib. After diagnosis he started cytoreductive therapy with cytarabine and hydroxyurea, then he begun therapy with imatinib 400 mg/day. After 3 months of treatment, he obtained a complete hematologic response (CHR) and a minor cytogenetic response (minor CyR). At 6 months CHR was confirmed, but bone marrow analysis showed increasing number of Ph+ cells (minimal CyR) and non significant reduction of BCR-ABL levels. According to ELN (European LeukemiaNet) guidelines, this is considered a suboptimal response. Clonal evolution, kinase domain mutations and reduced drug intake were excluded, thus we decided to early switch to nilotinib at 400 mg/BID. After 3 months of treatment we obtained a complete cytogenetic response (CCyR) and a strong reduction of BCR-ABL transcript, almost reaching a major molecular response (MMR). |
| first_indexed | 2024-12-12T03:54:05Z |
| format | Article |
| id | doaj.art-99c305f13d01494997bbd817c1bf308f |
| institution | Directory Open Access Journal |
| issn | 1973-4832 2283-3137 |
| language | English |
| last_indexed | 2024-12-12T03:54:05Z |
| publishDate | 2015-10-01 |
| publisher | SEEd |
| record_format | Article |
| series | Clinical Management Issues |
| spelling | doaj.art-99c305f13d01494997bbd817c1bf308f2022-12-22T00:39:18ZengSEEdClinical Management Issues1973-48322283-31372015-10-0156S232610.7175/cmi.v5i6S.11351066Early switch to nilotinib in a case of non-optimal response to imatinibAlessandra Iurlo0Tommaso Radice1Chiara De Philippis2Manuela Zappa3Mauro Pomati4Agostino Cortelezzi5Divisione di Ematologia-Fondazione Ca’ Granda, Ospedale Policlinico, Università di MilanoDivisione di Ematologia-Fondazione Ca’ Granda, Ospedale Policlinico, Università di MilanoDivisione di Ematologia-Fondazione Ca’ Granda, Ospedale Policlinico, Università di MilanoDivisione di Ematologia-Fondazione Ca’ Granda, Ospedale Policlinico, Università di MilanoDivisione di Ematologia-Fondazione Ca’ Granda, Ospedale Policlinico, Università di MilanoDivisione di Ematologia-Fondazione Ca’ Granda, Ospedale Policlinico, Università di MilanoWe report a case of excellent response to nilotinib in a 22 years old man with chronic myeloid leukemia in suboptimal response to imatinib. After diagnosis he started cytoreductive therapy with cytarabine and hydroxyurea, then he begun therapy with imatinib 400 mg/day. After 3 months of treatment, he obtained a complete hematologic response (CHR) and a minor cytogenetic response (minor CyR). At 6 months CHR was confirmed, but bone marrow analysis showed increasing number of Ph+ cells (minimal CyR) and non significant reduction of BCR-ABL levels. According to ELN (European LeukemiaNet) guidelines, this is considered a suboptimal response. Clonal evolution, kinase domain mutations and reduced drug intake were excluded, thus we decided to early switch to nilotinib at 400 mg/BID. After 3 months of treatment we obtained a complete cytogenetic response (CCyR) and a strong reduction of BCR-ABL transcript, almost reaching a major molecular response (MMR).https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/1135Chronic Myeloid LeukemiaEarly switchNilotinib |
| spellingShingle | Alessandra Iurlo Tommaso Radice Chiara De Philippis Manuela Zappa Mauro Pomati Agostino Cortelezzi Early switch to nilotinib in a case of non-optimal response to imatinib Clinical Management Issues Chronic Myeloid Leukemia Early switch Nilotinib |
| title | Early switch to nilotinib in a case of non-optimal response to imatinib |
| title_full | Early switch to nilotinib in a case of non-optimal response to imatinib |
| title_fullStr | Early switch to nilotinib in a case of non-optimal response to imatinib |
| title_full_unstemmed | Early switch to nilotinib in a case of non-optimal response to imatinib |
| title_short | Early switch to nilotinib in a case of non-optimal response to imatinib |
| title_sort | early switch to nilotinib in a case of non optimal response to imatinib |
| topic | Chronic Myeloid Leukemia Early switch Nilotinib |
| url | https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/1135 |
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