Granulocyte colony-stimulating factor reverses cytopenia and may permit cytogenetic responses in patients with chronic myeloid leukemia treated with imatinib mesylate.
Granulocyte colony-stimulating factor reverses cytopenia and may permit cytogenetic responses in patients with chronic myeloid leukemia treated with imatinib mesylate.
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发表时间：
2003
期刊：
影响因子：
10.1
通讯作者：
D. Marin;S. Marktel;N. Foot;M. Bua;J. Goldman;J. Apperley
中科院分区：
文献类型：
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作者：
D. Marin;S. Marktel;N. Foot;M. Bua;J. Goldman;J. Apperley
甲酸伊马替尼在大多数慢性髓性白血病（CML）慢性期患者中诱导主要或完全的细胞遗传学应答。然而，15-40%的患者出现中性粒细胞减少症和/或血小板减少症，因此需要减少剂量或中断治疗。复发性细胞减少的患者可能不太可能获得细胞遗传学反应。我们推测低剂量粒细胞集落刺激因子（G-CSF）联合伊马替尼可能提供临床益处。11例慢性（n=9）或加速（n=2）期CML患者在伊马替尼治疗6个月后不能耐受300 mg/天且没有细胞遗传学反应，接受G-CSF联合伊马替尼治疗。11名患者中有10名患者能够耐受剂量等于或大于300mg /天的伊马替尼，7名患者获得了主要（n=6）或完全（n=1）细胞遗传学反应。我们得出结论，G-CSF逆转伊马替尼的血液学毒性，从而可能增加细胞遗传学反应的比例。
Imatinib mesylate induces major or complete cytogenetic responses in the majority of patients with chronic myeloid leukemia (CML) in chronic phase. However, 15-40% of patients develop neutropenia and/or thrombocytopenia that makes it necessary to reduce the dosage or to interrupt treatment. Patients with recurrent cytopenias may be less likely to obtain cytogenetic responses. We speculated that low doses of granulocyte colony-stimulating factor (G-CSF) in conjunction with imatinib might offer clinical benefit. Eleven patients with CML in chronic (n=9) or accelerated (n=2) phase who could not tolerate 300 mg/day and had no cytogenetic response after 6 months of imatinib treatment received G-CSF in combination with imatinib. Ten of the 11 patients could then tolerate doses of imatinib equal to or greater than 300 mg/day and 7 patients achieved major (n=6) or complete (n=1) cytogenetic responses. We conclude that G-CSF reverses the hematologic toxicity of imatinib and may thereby increase the proportion of cytogenetic responses.