Isolated central nervous system relapse in lymphoid blast crisis chronic myeloid leukemia and acute lymphoblastic leukemia in patients on imatinib therapy
Isolated central nervous system relapse in lymphoid blast crisis chronic myeloid leukemia and acute lymphoblastic leukemia in patients on imatinib therapy
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DOI：
10.1080/10428190310001593184
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发表时间：
2004-02-01
影响因子：
2.6
通讯作者：
Lipton, JH
中科院分区：
文献类型：
--
作者：
Bujassoum, S;Rifkind, J;Lipton, JH
在I、II和III期研究中，费城染色体阳性的ALL和CML对伊马替尼（格列卫，STI571）表现出显著的应答。然而，伊马替尼对血脑屏障的渗透性很差，导致中枢神经系统的亚治疗水平。我们报告了2例接受伊马替尼治疗的患者，他们在3个月内实现了完全的细胞遗传学缓解，但随后出现了中枢神经系统复发，而在骨髓检查中仍保持完全的细胞遗传学缓解。在鞘内甲氨蝶呤和阿糖胞苷治疗后，两名患者均获得中枢神经系统缓解。
Philadelphia chromosome positive ALL and CML have shown remarkable responses to imatinib (Gleevec, STI571) in phase I, II and III studies. However, imatinib has very poor penetration of the blood brain barrier resulting in subtherapeutic levels in the CNS. We present 2 cases of patients treated with imatinib that achieved complete cytogenetic remission within 3 months who subsequently developed CNS relapses while remaining in complete cytogenetic remission on bone marrow examination. Both patients went on to achieve CNS remission following treatment with intrathecal methotrexate and cytarabine.