Korean J Pediatr Hematol Oncol.  2003 Apr;10(1):110-114.

Complete Remission by Imatinib Mesylate (Glivec) in a Child Relapsing with Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph (+) ALL) after Unrelated Donor Stem Cell Transplantation

• Kim YY
• Yoo YK
• Kim SY
• Jang PS
• Chung NG
• Cho B
• Jeong DC
• Lee SJ
• Kim HK

Abstract

The prognosis of patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph ALL) who relapsed after allogeneic stem cell transplantation (allo-SCT) is poor. Imatinib mesylate (Glivec (R) ) is an inhibitor of the ABL tyrosine kinase with potent antileukemic activity in advanced Ph ALL. The clinical effects of imatinib on Ph ALL recurring after allo-SCT have not been established. We describe the clinical activity of imatinib in a 7 year-old boy with Ph ALL relapsing after unrelated donor stem cell transplantation. Imatinib as a single agent resulted in rapid elimination of leukemic cells with ensuing prolonged neutropenia and thrombocytopenia. Subsequent hematological recovery by donor-derived cells was associated with grade 3 graft-versus-host disease (GvHD), which responded to cyclosporine A and steroid. Imatinib successfully induced hematologic, cytogenetic and molecular remission of Ph ALL, and restored complete donor chimerism, along with controllable GvHD.

Keyword

Philadelphia chromosome; Acute lymphoblastic leukemia; BCR/ABL; Imatinib mesylate; Stem cell transplantation

MeSH Terms

Child*
Chimerism
Cyclosporine
Cytogenetics
Graft vs Host Disease
Humans
Hydrogen-Ion Concentration
Male
Mesylates*
Neutropenia
Philadelphia Chromosome*
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Prognosis
Protein-Tyrosine Kinases
Stem Cell Transplantation*
Stem Cells*
Thrombocytopenia
Tissue Donors
Unrelated Donors*
Imatinib Mesylate
Cyclosporine
Mesylates
Protein-Tyrosine Kinases