Korean J Hematol.  2003 Aug;38(3):205-209.

Accelerated Phase Chronic Myeloid Leukemia in Complete Molecular Response with STI571

• Kim EJ
• Zang DY
• Ahn JS
• Lee YK
• Cho HC
• Kim YL
• Kim DW

Abstract

STI571 is an effective agent for the patients with chronic myeloid leukemia (CML). But, complete molecular response with STI571 is rarely reported in accelerated phase CML. Here we report a patient with accelerated phase CML who achieved complete molecular response with STI571. A 60-year old female patient visited emergency room with syncope. Her white blood cell count was 30,800/microliter (basophil 23%), hemoglobin 8.9g/dL, and platelet counts 2,748,000/microliter. Bone marrow was hypercellular with increase in megakaryocyte and basophils (15%). She was diagnosed as an accelerated phase CML. Seven days after stopping hydroxyurea, we used STI571 in a daily oral dose of 600mg. Generalized edema and skin rash were observed 15 days after treatment (all grade 1) and were controlled well with conservative management. Complete hematologic and cytogenetic responses were achieved after 1 month and 3 months of therapy with STI571 respectively. Complete molecular response was simultaneously proven by conventional reverse transcriptase PCR and real-time PCR analysis. The patient still remained in complete hematologic, cytogenetic, and molecular responses for 24 months. Treatment with STI571 was well tolerated and rapid hematologic improvement was observed. This case shows STI571 can induce complete molecular response as well as cytogenetic response in accelerated phase CML.

Keyword

Chronic myelogenous leukemia; STI571; Molecular response

MeSH Terms

Basophils
Bone Marrow
Cytogenetics
Edema
Emergency Service, Hospital
Exanthema
Female
Humans
Hydroxyurea
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Leukocyte Count
Megakaryocytes
Middle Aged
Platelet Count
Real-Time Polymerase Chain Reaction
Reverse Transcriptase Polymerase Chain Reaction
Syncope
Imatinib Mesylate
Hydroxyurea