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Imatinib combined with mitoxantrone/etoposide and cytarabine is an effective induction therapy for patients with chronic myeloid leukemia in myeloid blast crisis

BACKGROUND Despite advances in drug therapy and allogeneic stem cell transplantation (allo-SCT), the prognosis of patients with chronic myeloid leukemia (CML) in blast crisis remains poor. Imatinib has demonstrated synergistic effects in vitro with mitoxantrone, etoposide, and cytarabine. METHODS A...

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Main Authors: Frühauf, Stefan (Author) , Topaly, Julian (Author) , Buß, Eike Christian (Author) , Fischer, Thomas (Author) , Ottmann, Oliver G. (Author) , Emmerich, Bertold (Author) , Müller, Martin Christian (Author) , Schuld, Peter (Author) , Balleisen, Leopold (Author) , Hehlmann, Rüdiger (Author) , Ho, Anthony Dick (Author) , Hochhaus, Andreas (Author)
Format: Article (Journal)
Language:English
Published: 05 March 2007
In: Cancer
Year: 2007, Volume: 109, Issue: 8, Pages: 1543-1549
ISSN:1097-0142
DOI:10.1002/cncr.22535
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/cncr.22535
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/cncr.22535
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Author Notes:Stefan Fruehauf, Julian Topaly, Eike C. Buss, Thomas Fischer, Oliver G. Ottmann, Bertold Emmerich, Martin C. Müller, Peter Schuld, Leopold Balleisen, Rüdiger Hehlmann, Anthony D. Ho, Andreas Hochhaus
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Summary:BACKGROUND Despite advances in drug therapy and allogeneic stem cell transplantation (allo-SCT), the prognosis of patients with chronic myeloid leukemia (CML) in blast crisis remains poor. Imatinib has demonstrated synergistic effects in vitro with mitoxantrone, etoposide, and cytarabine. METHODS A Phase I/II trial was performed in patients with CML myeloid blast crisis. Patients were treated with imatinib + mitoxantrone/etoposide in four cohorts: mitoxantrone 10 mg/m2/day and etoposide 100 mg/m2/day for 2 or 3 consecutive days and imatinib 600 mg/day from Day 15 (cohorts 1 and 2) or from Day 1 (cohorts 3 and 4). After hematologic reconstitution after the cytopenic phase, cytarabine was given at a dose of 10 mg/m2/day in addition to imatinib as maintenance treatment. RESULTS A total of 16 patients were available for analysis, median age 59 years (range, 37-74). All patients who received more intensive induction treatment (cohorts 3 and 4, n = 7) achieved a hematologic response (HR). In contrast, HR was achieved in only 6 of 9 patients treated in cohorts 1 and 2. The induction treatment was well tolerated. Six patients who achieved HR received an allo-SCT with myeloablative conditioning. The median survival in the transplant group was 16.2 months vs 4.7 months in the group with conventional treatment only (P = .067). CONCLUSIONS The combination of mitoxantrone/etoposide and imatinib is well tolerated, with mild nonhematologic toxicity even in older patients. Eligible patients benefit from allo-SCT after response to the induction treatment. Cancer 2007. © 2007 American Cancer Society.
Item Description:Gesehen am 02.11.2021
Physical Description:Online Resource
ISSN:1097-0142
DOI:10.1002/cncr.22535

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