Staber Philipp B, Brezinschek Ruth, Linkesch Werner, Sill Heinz, Neumeister Peter
Division of Hematology, Dept. of Internal Medicine, Karl Franzens University Graz, Austria.
Haematologica. 2003 Aug;88(8):ECR29.
We report a chronic myeloid leukemia (CML) patient in chronic phase (CP) who developed blast crisis (BC) under imatinib mesylate administered in a dose reduced and non-continuous fashion because of hematologic intolerance. The patient underwent nonmyeloablative stem-cell transplant from a matched unrelated donor, but failed to achieve full donor chimerism and antileukemic response resulting in persistence of advanced disease. Complete hematologic, cytogenetic and molecular responses were attained 5 weeks after readministration of regularly dosed imatinib and two-step nested RT-PCR confirmed molecular remission throughout a 6 month follow-up period. This is the first case demonstrating that imatinib mesylate is a highly effective and safe treatment option to induce durable molecular remission in patients with CML who remain in myeloid blast crisis after nonmyeloablative allogeneic stem-cell transplantation.
我们报告了1例慢性期慢性髓性白血病（CML）患者，该患者因血液学不耐受而以减量和不连续方式服用甲磺酸伊马替尼，随后发生了急变期（BC）。该患者接受了来自匹配无关供者的非清髓性干细胞移植，但未能实现完全供者嵌合和抗白血病反应，导致进展期疾病持续存在。在重新给予常规剂量的伊马替尼5周后，实现了完全血液学、细胞遗传学和分子反应，两步巢式逆转录聚合酶链反应（RT-PCR）证实在6个月的随访期内一直处于分子缓解状态。这是首例表明甲磺酸伊马替尼是一种高效且安全的治疗选择，可诱导非清髓性异基因干细胞移植后仍处于髓系急变期的CML患者实现持久分子缓解的病例。
