Share This Article:

Cytogenetic Response in Chronic Myeloid Leukaemia Patients Treated with Imatinib Mesylate Homolog-Drugs: 6 Year’s Transitional Study

Abstract Full-Text HTML Download Download as PDF (Size:519KB) PP. 453-459
DOI: 10.4236/jct.2014.55052    2,936 Downloads   4,095 Views   Citations

ABSTRACT

Background: Treatment for Chronic Myeloid Leukaemia (CML) is mainly imatinib mesylate (IM) from original-brand, Glivec? or generic-type homologs, Imatib?. Materials and Methods: A collection of 149 CML patients was treated over a period of 6 years at Hiwa hospital. These patients were clustered into three groups: Group A was treated with Imatib for more than one year. All survivors of group A patients were switched to Glivec, classified as group B. Group C received only Glivec after June 2011. Imatib and Glivec are administered at doses 400-, 600- and 800-mg according to the CML stage. Results: Among group A patients, 68 (60%) were in complete haematological response (CHR), 32 (28.3%) developed acceleration and 13 (11.5%) patients were deceased. After switching to Glivec (group B), 69 (69%) patients remained in CHR, 10 (10%) patients weredeceased and 21 (21%) patients remained in acceleration. Of the 36 patients in group C, 33 (91.7%) were in CHR, 1 (2.8%) were in acceleration and 2 (5.5%) deceased. Those patients with CHR were tested randomly for BCR/ABL by FISH, and only 1/25 (4%) patients were found with complete cytogenetic response (CCyR) in group A, while 31/42 (73.8%) and 13/17 (76.5%) have CCyR in group B and C, respectively. Conclusions: Our results demonstrate a less cytogenetic response to treatment in patients of CML, who received the Imatib therapy, while a significant cytogenetic remission was found in patients with CHR after they switched to Glivec.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Khoshnaw, N. , Francis, B. , Safar, B. , Mahmood, S. and Nore, B. (2014) Cytogenetic Response in Chronic Myeloid Leukaemia Patients Treated with Imatinib Mesylate Homolog-Drugs: 6 Year’s Transitional Study. Journal of Cancer Therapy, 5, 453-459. doi: 10.4236/jct.2014.55052.

References

[1] Fialkow, P.J., Jacobson, R.J. and Papayannopoulou, T. (1977) Chronic Myelocytic Leukemia: Clonal Origin in a Stem Cell Common to the Granulocyte, Erythrocyte, Platelet and Monocyte/Macrophage. American Journal of Medicine, 63, 125-130. http://dx.doi.org/10.1016/0002-9343(77)90124-3
[2] Faderl, S., Talpaz, M., Estrov, Z., O’Brien, S., Kurzrock, R. and Kantarjian, H.M. (1999) The Biology of Chronic Myeloid Leukemia. The New England Journal of Medicine, 341, 164-172.
http://dx.doi.org/10.1056/NEJM199907153410306
[3] Griffin, J.D., Todd, R.F., Ritz, J., Nadler, L.M., Canellos, G.P., Rosenthal, D., Gallivan, M., Beveridge, R.P., Weinstein, H., Karp, D., et al. (1983) Differentiation Patterns in the Blastic Phase of Chronic Myeloid Leukemia. Blood, 61, 85-91.
[4] Rowley, J.D. (1973) Letter: A New Consistent Chromosomal Abnormality in Chronic Myelogenous Leukaemia Identified by Quinacrine Fluorescence and Giemsa Staining. Nature, 243, 290-293.
http://dx.doi.org/10.1038/243290a0
[5] Shtivelman, E., Lifshitz, B., Gale, R.P. and Canaani, E. (1985) Fused Transcript of abl and bcr Genes in Chronic Myelogenous Leukaemia. Nature, 315, 550-554. http://dx.doi.org/10.1038/315550a0
[6] Kurzrock, R., Gutterman, J.U. and Talpaz, M. (1988) The Molecular Genetics of Philadelphia Chromosome-Positive Leukemias. The New England Journal of Medicine, 319, 990-998.
http://dx.doi.org/10.1056/NEJM198810133191506
[7] Melo, J.V. (1996) The Molecular Biology of Chronic Myeloid Leukaemia. Leukemia, 10, 751-756.
[8] Sawyers, C.L. (1999) Chronic Myeloid Leukemia. The New England Journal of Medicine, 340, 1330-1340. http://dx.doi.org/10.1056/NEJM199904293401706
[9] Savage, D.G. and Antman, K.H. (2002) Imatinib Mesylate―A New Oral Targeted Therapy. The New England Journal of Medicine, 346, 683-693. http://dx.doi.org/10.1056/NEJMra013339
[10] Hochhaus, A., Lin, F., Reiter, A., Skladny, H., van Rhee, F., Shepherd, P.C., Allan, N.C., Hehlmann, R., Goldman, J.M. and Cross, N.C. (1995) Variable Numbers of BCR-ABL Transcripts Persist in CML Patients Who Achieve Complete Cytogenetic Remission with Interferon-Alpha. British Journal of Haematology, 91, 126-131. http://dx.doi.org/10.1111/j.1365-2141.1995.tb05257.x
[11] O’Brien, S.G., Guilhot, F., Larson, R.A., Gathmann, I., Baccarani, M., Cervantes, F., Cornelissen, J.J., Fischer, T., Hochhaus, A., Hughes, T., et al. (2003) Imatinib Compared with Interferon and Low-Dose Cytarabine for Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia. The New England Journal of Medicine, 348, 994-1004. http://dx.doi.org/10.1056/NEJMoa022457
[12] Hehlmann, R., Heimpel, H., Hasford, J., Kolb, H.J., Pralle, H., Hossfeld, D.K., Queisser, W., Loffler, H., Hochhaus, A., Heinze, B., et al. (1994) Randomized Comparison of Interferon-Alpha with Busulfan and Hydroxyurea in Chronic Myelogenous Leukemia. The German CML Study Group. Blood, 84, 4064-4077.
[13] Talpaz, M., Kantarjian, H., Kurzrock, R., Trujillo, J.M. and Gutterman, J.U. (1991) Interferon-Alpha Produces Sustained Cytogenetic Responses in Chronic Myelogenous Leukemia. Philadelphia Chromosome-Positive Patients. Annals of Internal Medicine, 114, 532-538.
http://dx.doi.org/10.7326/0003-4819-114-7-532
[14] Druker, B.J., Tamura, S., Buchdunger, E., Ohno, S., Segal, G.M., Fanning, S., Zimmermann, J. and Lydon, N.B. (1996) Effects of a Selective Inhibitor of the Abl Tyrosine Kinase on the Growth of Bcr-Abl Positive Cells. National Medicine, 2, 561-566. http://dx.doi.org/10.1038/nm0596-561
[15] Druker, B.J., Guilhot, F., O’Brien, S.G., Gathmann, I., Kantarjian, H., Gattermann, N., Deininger, M.W., Silver, R.T., Goldman, J.M., Stone, R.M., et al. (2006) Five-Year Follow-Up of Patients Receiving Imatinib for Chronic Myeloid Leukemia. The New England Journal of Medicine, 355, 2408-2417. http://dx.doi.org/10.1056/NEJMoa062867
[16] Hughes, T.P., Hochhaus, A., Branford, S., Muller, M.C., Kaeda, J.S., Foroni, L., Druker, B.J., Guilhot, F., Larson, R.A., O’Brien, S.G., et al. (2010) Long-Term Prognostic Significance of Early Molecular Response to Imatinib in Newly Diagnosed Chronic Myeloid Leukemia: An Analysis from the International Randomized Study of Interferon and STI571 (IRIS). Blood, 116, 3758-3765.
http://dx.doi.org/10.1182/blood-2010-03-273979
[17] Asfour, I.A. and Elshazly, S.A. (2009) Changing Therapy from Glivecto a “Copy” Imatinib Results in a Worsening of Chronic Myeloid Leukemia Disease Status: Two Case Reports. Cases Journal, 2, 9342. http://dx.doi.org/10.1186/1757-1626-2-9342
[18] Mattar, M. (2010) Failure of Copy Imatib (CIPLA, India) to Maintain Hematologic and Cytogenetic Responses in Chronic Myeloid Leukemia in Chronic Phase. International Journal of Hematology, 91, 104-106. http://dx.doi.org/10.1007/s12185-009-0431-1
[19] Goubran, H.A. (2009) Failure of a Non-Authorized Copy Product to Maintain Response Achieved with Imatinib in a Patient with Chronic Phase Chronic Myeloid Leukemia: A Case Report. Journal of Medical Case Reports, 3, 7112. http://dx.doi.org/10.1186/1752-1947-3-7112
[20] Kantarjian, H.M., Dixon, D., Keating, M.J., Talpaz, M., Walters, R.S., McCredie, K.B. and Freireich, E.J. (1988) Characteristics of Accelerated Disease in Chronic Myelogenous Leukemia. Cancer, 61, 1441-1446. http://dx.doi.org/10.1002/1097-0142(19880401)61:7<1441::AID-CNCR2820610727>3.0.CO; 2-C
[21] Sokal, J.E., Baccarani, M., Russo, D. and Tura, S. (1988) Staging and Prognosis in Chronic Myelogenous Leukemia. Seminars in Hematology, 25, 49-61.
[22] Kantarjian, H.M., Keating, M.J., Talpaz, M., Walters, R.S., Smith, T.L., Cork, A., McCredie, K.B. and Freireich, E.J. (1987) Chronic Myelogenous Leukemia in Blast Crisis. Analysis of 242 Patients. American Journal of Medicine, 83, 445-454. http://dx.doi.org/10.1016/0002-9343(87)90754-6
[23] Baccarani, M., Saglio, G., Goldman, J., Hochhaus, A., Simonsson, B., Appelbaum, F., Apperley, J., Cervantes, F., Cortes, J., Deininger, M., et al. (2006) Evolving Concepts in the Management of Chronic Myeloid Leukemia: Recommendations from an Expert Panel on Behalf of the European Leukemia Net. Blood, 108, 1809-1820. http://dx.doi.org/10.1182/blood-2006-02-005686
[24] Baccarani, M., Cortes, J., Pane, F., Niederwieser, D., Saglio, G., Apperley, J., Cervantes, F., Deininger, M., Gratwohl, A., Guilhot, F., et al. (2009) Chronic Myeloid Leukemia: An Update of Concepts and Management Recommendations of European Leukemia Net. Journal of Clinical Oncology, 27, 6041-6051. http://dx.doi.org/10.1200/JCO.2009.25.0779
[25] O’Brien, S., Berman, E., Borghaei, H., Deangelo, D.J., Devetten, M.P., Devine, S., Erba, H.P., Gotlib, J., Jagasia, M., Moore, J.O., et al. (2009) NCCN Clinical Practice Guidelines in Oncology: Chronic Myelogenous Leukemia. Journal of the National Comprehensive Cancer Network, 7, 984-1023.

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.