Tohoku J. Exp. Med., 2004, 204(1)

Case Report

Imatinib Mesylate in Conjunction with Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Philadelphia Chromosome Positive Leukemias: Report of 4 Cases

MINAMI YAMADA, KOICHI MIYAMURA, TOHRU FUJIWARA, HISAYUKI YOKOYAMA, YASUO TOMIYA, KENICHI ISHIZAWA, HIDEO HARIGAE,¹ JUNICHI KAMEOKA and TAKESHI SASAKI

Department of Rheumatology and Hematology and ¹Molecular Diagnostics, Tohoku University Graduate School of Medicine, Sendai 980-8574

We described here four patients diagnosed with Philadelphia chromosome positive (Ph+) leukemia, consisting of chronic myeloid leukemia (CML) (n=2) and Ph+ acute lymphoblastic leukemia (ALL) (n=2). All patients were treated with imatinib mesylate (300-400 mg/day) for the treatment of relapsed CML after allogeneic hematopoietic stem cell transplantation (SCT) (n=2), relapsed Ph+ ALL after SCT (n=1), and Ph+ ALL preceding SCT (n=1). Significant clinical and molecular responses were observed in all patients and three of them achieved sustained molecular remission. Imatinib was well tolerated and did not induce noticeable graft versus host disease although one patient presented severe skin rash (Grade III). Notably, serum cyclosporine A concentration increased after the initiation of imatinib treatment, probably through competitive inhibition of P450 3A4 isoenzyme. Our data suggest that imatinib in conjunction with SCT for the Ph+ leukemia may be a promising treatment strategy.

keywords —— imatinib mesylate; STI571; Philadelphia chromosome positive leukemia; allogeneic hematopoietic stem cell transplantation

© 2004 Tohoku University Medical Press

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Address for reprints: Minami Yamada, M.D., Department of Rheumatology and Hematology, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.

e-mail: yminami@mail.tains.tohoku.ac.jp