International Journal of Hematology

, Volume 107, Issue 6, pp 709–711 | Cite as

10-year complete remission in a Philadelphia chromosome-positive acute lymphoblastic leukemia patient using imatinib without high-intensity chemotherapy or allogeneic stem cell transplantation

  • Katsumichi Fujimaki
  • Yukako Hattori
  • Hideaki Nakajima
Case Report
  • 156 Downloads

Abstract

The outcome of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL) has improved with the use of tyrosine kinase inhibitors, such as imatinib and dasatinib. We report a 63-year-old woman with Ph-ALL who maintained complete remission for 10 years using imatinib without high-intensity chemotherapy or allogeneic stem cell transplantation. She underwent induction therapy with imatinib plus prednisolone and achieved complete remission by day 53. Imatinib was continued until 103 months, when it was stopped in response to renal dysfunction; however, the patient continued to exhibit molecular remission at 120 months. This is the first report in the literature describing a patient with Ph-ALL who achieved remission for more than 10 years after treatment only with imatinib.

Keywords

Philadelphia chromosome Acute lymphoblastic leukemia Imatinib Complete remission 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Secker-Walker LM, Craig JM, Hawkins JM, Hoffbrand AV. Philadelphia positive acute lymphoblastic leukemia in adults: age distribution, BCR breakpoint and prognostic significance. Leukemia. 1991;5:196–9.PubMedGoogle Scholar
  2. 2.
    Burmeister T, Schwartz S, Bartram CR, Gokbuget N, Hoelzer D, Thiel E. Patients’ age and BCR-ABL frequency in adult B-precursor ALL: a retrospective analysis from the GMALL study group. Blood. 2008;112:918–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Larson RA. Management of acute lymphoblastic leukemia in older patients. Semin Hematol. 2006;43:126–33.CrossRefPubMedGoogle Scholar
  4. 4.
    Chiaretti S, Vitale A, Cazzaniga G, Orlando SM, Silvestri D, Fazi P, et al. Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts. Haematologica. 2013;98:1702–10.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Yanada M, Takeuchi J, Sugiura I, Akiyama H, Usui N, Yagasaki F, et al. High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR-ABL—positive acute lymphoblastic leukemia: a Phase II Study by the Japan Adult Leukemia Study Group. J Clin Oncol. 2006;24:460–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Fujisawa S, Mizuta S, Akiyama H, Ueda Y, Aoyama Y, Hatta Y, et al. Phase II study of imatinib-based chemotherapy for newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia. Am J Hematol. 2017;92:367–74.CrossRefPubMedGoogle Scholar
  7. 7.
    Daver N, Thomas D, Ravandi F, Cortes J, Garris R, Jabbour E, et al. Final report of a phase II study of imatinib mesylate with hyper-CVAD for the front-line treatment of adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Haematologica. 2015;100:653–61.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Ravandi F, O’Brien SM, Cortes JE, Thomas DM, Garris R, Faderl S, et al. Long-term follow-up of a phase 2 study of chemotherapy plus dasatinib for the initial treatment of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Cancer. 2015;121:4158–64.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Vignetti M, Fazi P, Cimino G, Martinelli G, Di Raimondo F, Ferrara F, et al. Imatinib plus steroids induces complete remissions and prolonged survival in elderly Philadelphia chromosome-positive patients with acute lymphoblastic leukemia without additional chemotherapy: results of the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) LAL0201-B protocol. Blood. 2007;109:3676–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Foà R, Vitale A, Vignetti M, Meloni G, Guarini A, De Propris MS, et al. Dasatinib as first-line treatment for adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood. 2011;118:6521–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Takeuchi J, Kusumoto S, Akiyama H, Kanda Y, Izutsu K. JSH guideline for tumors of hematopoietic and lymphoid tissues-leukemia: 3. Acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL). Int J Hematol. 2017;106:732–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Sabina C, Antonella V, Loredana E, Anna LF, Silvana A, Alfonso P, et al. Multicenter total therapy GIMEMA LAL 1509 protocol for de novo adult Ph+ acute lymphoblastic leukemia (ALL) patients. Updated results and refined genetic-based prognostic stratification. Blood. 2015;126:81.Google Scholar

Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  1. 1.Department of HematologyFujisawa City HospitalFujisawaJapan
  2. 2.Department of Hematology and Clinical ImmunologyYokohama City University School of MedicineYokohamaJapan

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