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Pre-emptive treatment with nilotinib after second allogeneic transplantation in a Philadelphia chromosome-positive acute lymphoblastic leukemia patient with high risk of relapse.

Author(s): Kang BW, Moon JH, Chae YS, Kim JG, Kim SN, Sohn SK

Affiliation(s): Department of Hematology/Oncology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

Publication date & source: 2010, Acta Haematol., 123(4):242-7. Epub 2010 May 12.

Publication type: Review

Although a tyrosine kinase inhibitor (TKI) targeted for BCR/ABL administered in combination with chemotherapy has been established as the current first-line strategy for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), relapse remains common, even among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Recently, preclinical and preliminary clinical studies suggested a potential therapeutic role of nilotinib, a second-generation TKI, in Ph+ ALL, including patients who have undergone prior allo-HSCT. This report presents the case of a patient with a post-transplant persistent positive BCR/ABL value, who was treated with imatinib and dasatinib before a second allo-HSCT. The patient started taking nilotinib due to a persistent BCR/ABL value and residual mass in her ovaries after a second allo-HSCT. Nine months after introducing nilotinib, the patient achieved complete molecular remission, and despite the continued existence of the residual ovary mass, no hot spot was found in her positron emission tomography scan. The present paper also reviews existing literature on the pre-emptive use of nilotinib for Ph+ ALL patients who received all-HSCT. 2010 S. Karger AG, Basel.

Page last updated: 2010-10-05

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