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Pre-Emptive Treatment with Nilotinib after Second Allogeneic Transplantation in a Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Patient with High Risk of Relapse

Pre-Emptive Treatment with Nilotinib after Second Allogeneic Transplantation in a Philadelphia... Although a tyrosine kinase inhibitor (TKI) targeted for BCR/ABL administered in combination with chemotherapy has been established as the current first-line strategy for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), relapse remains common, even among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Recently, preclinical and preliminary clinical studies suggested a potential therapeutic role of nilotinib, a second-generation TKI, in Ph+ ALL, including patients who have undergone prior allo-HSCT. This report presents the case of a patient with a post-transplant persistent positive BCR/ABL value, who was treated with imatinib and dasatinib before a second allo-HSCT. The patient started taking nilotinib due to a persistent BCR/ABL value and residual mass in her ovaries after a second allo-HSCT. Nine months after introducing nilotinib, the patient achieved complete molecular remission, and despite the continued existence of the residual ovary mass, no hot spot was found in her positron emission tomography scan. The present paper also reviews existing literature on the pre-emptive use of nilotinib for Ph+ ALL patients who received all-HSCT. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Haematologica Karger

Pre-Emptive Treatment with Nilotinib after Second Allogeneic Transplantation in a Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Patient with High Risk of Relapse

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References (26)

Publisher
Karger
Copyright
© 2010 S. Karger AG, Basel
ISSN
0001-5792
eISSN
1421-9662
DOI
10.1159/000314538
Publisher site
See Article on Publisher Site

Abstract

Although a tyrosine kinase inhibitor (TKI) targeted for BCR/ABL administered in combination with chemotherapy has been established as the current first-line strategy for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), relapse remains common, even among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Recently, preclinical and preliminary clinical studies suggested a potential therapeutic role of nilotinib, a second-generation TKI, in Ph+ ALL, including patients who have undergone prior allo-HSCT. This report presents the case of a patient with a post-transplant persistent positive BCR/ABL value, who was treated with imatinib and dasatinib before a second allo-HSCT. The patient started taking nilotinib due to a persistent BCR/ABL value and residual mass in her ovaries after a second allo-HSCT. Nine months after introducing nilotinib, the patient achieved complete molecular remission, and despite the continued existence of the residual ovary mass, no hot spot was found in her positron emission tomography scan. The present paper also reviews existing literature on the pre-emptive use of nilotinib for Ph+ ALL patients who received all-HSCT.

Journal

Acta Haematologica – Karger

Published: Jan 1, 2010

Keywords: Imatinib; Nilotinib; Acute lymphoblastic leukemia, Ph+; Allogeneic hematopoietic stem cell transplantation; Dasatinib; Philadelphia chromosome

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