Efficacy of Molecular Response at 1 or 3 Months after the Initiation of Dasatinib Treatment Can Predict an Improved Response to Dasatinib in Imatinib-Resistant or Imatinib-Intolerant Japanese Patients with Chronic Myelogenous Leukemia during the Chronic Phase
-
- Inokuchi Koiti
- Division of Hematology, Department of Internal Medicine, Nippon Medical School
-
- Kumagai Takashi
- Department of Hematology, Ohme Municipal General Hospital
-
- Matsuki Eri
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine
-
- Ohashi Kazuteru
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
-
- Shinagawa Atsushi
- Department of Internal Medicine, Hitachi General Hospital
-
- Hatta Yoshihiro
- Department of Hematology and Rheumatology, Nihon University School of Medicine
-
- Takeuchi Jin
- Department of Hematology and Rheumatology, Nihon University School of Medicine
-
- Yoshida Chikashi
- Department of Hematology, National Hospital Organization Mito Medical Center
-
- Wakita Hisashi
- Division of Hematology and Oncology, Japanese Red Cross Society, Narita Red Cross Hospital
-
- Kozai Yasuji
- Department of Hematology, Tokyo Metropolitan Tama Medical Center
-
- Shirasugi Yukari
- Division of Hematology, Department of Internal Medicine, Tokai University School of Medicine
-
- Fujisawa Shin
- Department of Hematology, Yokohama City University Medical Center
-
- Iwase Osamu
- Division of Hematology, Hachioji Medical Center, Tokyo Medical University
-
- Yano Shingo
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine
-
- Okamoto Shinichiro
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine
-
- Oba Koji
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan & Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo
-
- Sakamoto Junichi
- Tokai Central Hospital
-
- Sakamaki Hisashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
この論文をさがす
抄録
Dasatinib is a BCR-ABL kinase inhibitor with improved potency compared with imatinib, for which efficacy and safety in imatinib-resistant and imatinib-intolerant patients with chronic myelogenous leukemia (CML) have been established. Here, an open-label phase II study evaluated the efficacy and safety of dasatinib in 50 Japanese patients with imatinib-resistant or imatinib-intolerant CML during the chronic phase (CML-CP). Dasatinib was effective in imatinib-resistant and imatinib-intolerant patients. After 12 months of dasatinib therapy, 35 patients (70%) had achieved a major molecular response (MMR) and 16 patients (32%) had achieved a complete molecular response (CMR). Among the imatinib-resistant CML-CP cohort, 21 and 8 patients had achieved an MMR and a CMR after 12 months of dasatinib therapy, respectively. Among the imatinib-intolerant CML-CP cohort, 14 and 8 patients had achieved an MMR and a CMR after 12 months of dasatinib therapy, respectively. After 18 months of dasatinib therapy, 38 out of 50 patients (76.0%) had achieved an MMR and 19 patients (38.0%) had achieved a CMR. A lower level of BCR-ABL transcript at 1 or 3 months after the initiation of dasatinib treatment was more strongly correlated with the BCR-ABL transcript level at 12 and 18 months (p ＜ 0.001) than a higher level of BCR-ABL. The T315I mutation was identified in two patients receiving dasatinib therapy. Dasatinib was generally well tolerated, with only 3 patients (5%) having treatment discontinuation as a result of adverse hematologic events (thrombocytopenia, anemia, neutropenia) and/or non-hematologic events at a 12-month follow-up evaluation. Dasatinib was a safe and effective treatment for Japanese patients with imatinib-resistant or imatinib-intolerant CML. In addition, the molecular response at 1 or 3 months predicted a response to dasatinib at 12 or 18 months.
収録刊行物
-
- Ｊｏｕｒｎａｌ ｏｆ Ｃｌｉｎｉｃａｌ ａｎｄ Ｅｘｐｅｒｉｍｅｎｔａｌ Ｈｅｍａｔｏｐａｔｈｏｌｏｇｙ
-
Ｊｏｕｒｎａｌ ｏｆ Ｃｌｉｎｉｃａｌ ａｎｄ Ｅｘｐｅｒｉｍｅｎｔａｌ Ｈｅｍａｔｏｐａｔｈｏｌｏｇｙ 54 (3), 197-204, 2014
日本リンパ網内系学会