TREATMENT OF CHRONIC MYELOID LEUKEMIA IN ACCELERATED PHASE AND BLASTIC CRISIS WITH IMATINIB
Autori:
Joško Bulum, Boris Labar, Mirta Mikulić, Vinko Bogdanic', Dubravka Sertić, Damir Nemet, Velka Krecak-Gveric, Jasna Kovacevic, Ranka Serventi-Seiwerth, Sanja Mrsic-Davidovic, Renata Zadro, Dubravka Boban
Sažetak
Sažetak. Kronična mijeloična leukemija (Ph+ KML) pozitivna na Philadelphia kromosom u uznapredovaloj fazi bolesti rezistentna je na uobičajeno citostatsko liječenje. Imatinib mesilat pokazao se vrlo dj elotvomirn u tih bolesnika. U radu su prikazani naši preliminarni rezultati. Tijekom 9 mjeseci imatinib mesilatom liječeno je 15 bolesnika, 9 u ubrzanoj fazi bolesti i 6 u blastičnoj krizi. Terapijski učinak određen je hematološkim i citogenetičkim odgovorom. Kompletna hematološka remisija postignuta je u 12 bolesnika (80%). Citogenetički odgovor utvrđen je u 8 bolesnika (53%) od čega u 6 bolesnika (40%) vrlo dobar. Tijekom 9 mjeseci liječenja u 9 bolesnika (60%) došlo je do progresije bolesti zbog čega su 4 bolesnika 1Irnrla. Najčešće nuspojave liječenja su eden1i, mučnina, neutropenija i trombocitopenija. Liječenjem imatinib mesilatom postignut je dobar, ali kratkotrajan, učinak u ubrzanoj fazi i blastičnoj krizi Ph+ KML.
Summary
Summary. Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML), in advanced stage of disease, is resistant to standard chemotherapy. Imatinib was found to be effective in these patients. This paper shows our preliminary results. Imatinib mesylate was given to 15 patients during a 9-month period. Nine of them were in accelerated phase and 6 in blastic crisis of Ph+ CML. Patients were evaluated for hematologic and cytogenetic responses. Imatinib mesylate induced complete haematologic response in 12 patients (80% and cytogenetic response in 8 patients (53%). Six patients (40%) had a major cytogenetic response. After a 9-month follow up Ph+ CML progressed in 9 patients (60%) and 4 of them died. The most frequent adverse effects were edema, nausea, neutropenia and thrombocytopenia. Imatinib mesylate has a substantial, but short term activity in the accelerated phase and blastic crisis of the Ph+ CML.
