Efficacy of imatinib plus granulocyte-colony-stimulating factor for treatment of patients with chronic myeloid leukemia
10.3760/cma.j.issn.1009-9921.2011.02.010
- VernacularTitle:伊马替尼联合粒细胞集落刺激因子治疗慢性粒细胞白血病11例
- Author:
Huifang ZHAO
;
Yongping SONG
;
Baijun FANG
;
Ning LI
;
Xudong WEI
- Publication Type:Journal Article
- Keywords:
Leukemia,myeloid,chronic;
Imatinib;
Granulocyte-colony-stimulating factor
- From:
Journal of Leukemia & Lymphoma
2011;20(2):92-94
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the treatment effect by addition of granulocyte-colony-stimulating factor (G-CSF) that could reduce the level of residual disease in patients with Ph-positive chronic myeloid leukemia (CML) who appeared to have achieved a suboptimal response to imatinib (IM) alone. Methods Eleven patients with CML who had achieved≥ 35 % Ph-negativity on treatment of IM were enrolled. The initial dose of imatinib was 400 mg or 600 mg orally daily, and G-CSF, 5 μg/kg subcutaneously daily. The administration of G-CSF was postponed or interrupted in the event of leukocytosis (leukocytes ≥ 30 ×109/L) until the whitecell count fell ＜20 × 109/L. Efficacy was assessed by serial monitoring of blood levels of bcr-abl transcripts.Treatment with G-CSF was discontinued if the patient did not achieve a reduction in the transcript level of at least 0.5 log after 6 months. For patients whose bcr-abl transcript levels continued to decline but had not yet reached molecular remission, treatment was designed to continue for 1 to 6 months. Results Of 11 evaluable patients, nine had an appreciable decline in bcr-abl transcript levels(include 7 cases the reduction was greater than 1 log and 2 cases the reduction was greater than 0.5 log), 2 cases the reduction was lower than 0.5 log.In 7 cases the reduction was greater than 1 log, including five patients who did not achieved complete cytogenetic response and two patients achieved complete molecular responses. No bleeding episodes occurred.No patient discontinued therapy because of toxicity and there were no treatment-related deaths. Conclusion The addition of G-CSF should be considered safely and successfully for patients who fail to obtain optimal response to IM alone and this approach deserves further evaluation.
