CNS blast crisis of chronic myelogenous leukemia in a patient with a major cytogenetic response in bone marrow associated with low levels of imatinib mesylate and its N-desmethylated metabolite in cerebral spinal fluid

被引：39

作者：

Bornhauser, M ^{[1
]}

Jenke, A ^{[1
]}

Freiberg-Richter, J ^{[1
]}

Radke, J ^{[1
]}

Schuler, US ^{[1
]}

Mohr, B ^{[1
]}

Ehninger, G ^{[1
]}

Schleyer, E ^{[1
]}

机构：

[1] Tech Univ Dresden, Klinikum Carl Gustav Carus, Med Klin & Poliklin 1, D-01307 Dresden, Germany

来源：

ANNALS OF HEMATOLOGY | 2004年 / 83卷 / 06期

关键词：

imatinib mesylate; CML; CNS involvement; pharmacokinetics;

D O I：

10.1007/s00277-003-0829-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Imatinib mesylate (ST1571) is a very effective treatment option for Ph+ chronic myeloid leukemia (CML) in chronic phase. Secondary treatment failures have mostly been observed in patients with advanced stages of disease. We report the case of a patient who unexpectedly experienced blast crisis of the central nervous system although having achieved complete cytogenetic remission in the bone marrow. The levels of ST1571 and its metabolite N-desmethyl STI were 40-fold lower in the cerebral spine fluid than in plasma. The risk of CNS disease has to be kept in mind when patients with CML in chronic phase who are at an increased risk for blastic transformation are treated with imatinib mesylate.

引用

页码：401 / 402

页数：2

共 5 条

[1]

Hochhaus A, 2001, SCIENCE, V293, P2163

[2] MDR1 gene overexpression confers resistance to imatinib mesylate in leukemia cell line models [J].

Mahon, FX ;

Belloc, F ;

Lagarde, V ;

Chollet, C ;

Moreau-Gaudry, F ;

Reiffers, J ;

Goldman, JM ;

Melo, JV .

BLOOD, 2003, 101 (06) :2368-2373

[3] Low concentrations of STI571 in the cerebrospinal fluid:: a case report [J].

Petzer, AL ;

Gunsilius, E ;

Hayes, M ;

Stockhammer, G ;

Duba, HC ;

Schneller, F ;

Grünewald, K ;

Poewe, W ;

Gastl, G .

BRITISH JOURNAL OF HAEMATOLOGY, 2002, 117 (03) :623-625

[4] Imatinib mesylate has limited activity against the central nervous system involvement of Philadelphia chromosome-positive acute lymphoblastic leukaemia due to poor penetration into cerebrospinal fluid [J].

Takayama, N ;

Sato, N ;

O'Brien, SG ;

Ikeda, Y ;

Okamoto, SI .

BRITISH JOURNAL OF HAEMATOLOGY, 2002, 119 (01) :106-108

[5] The CNS is a sanctuary for leukemic cells in mice receiving imatinib mesylate for Bcr/Abl-induced leukemia [J].

Wolff, NC ;

Richardson, JA ;

Egorin, M ;

Ilaria, RL .

BLOOD, 2003, 101 (12) :5010-5013

← 1 →