Discontinuation of tyrosine kinase inhibitors before epiphyseal closure leading to improved short stature in pediatric chronic myelogenous leukemia
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- FUKUI Wataru
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- OGURA Taemi
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- AZUMI Shohei
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- OGATA Hideto
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- KAWAGUCHI Koji
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- TAKACHI Takayuki
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- HORIKOSHI Yasuo
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
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- UEMATSU Ayumi
- Department of Endocrinology and Metabolism, Shizuoka Children’s Hospital
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- SHIMADA Hiroyuki
- Department of Pediatrics, Keio University School of Medicine
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- WATANABE Kenichiro
- Department of Hematology and Oncology, Shizuoka Children’s Hospital
Bibliographic Information
- Other Title
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- 骨端線閉鎖前にチロシンキナーゼ阻害薬を中止し低身長の改善を認めた小児慢性骨髄性白血病
Abstract
<p>A 3-year-old boy was referred to our hospital with splenomegaly. Blood tests revealed hyperleukocytosis and bone marrow examination showed major BCR::ABL1 fusion, leading to the diagnosis of chronic myelogenous leukemia (CML). Due to intolerance, the tyrosine kinase inhibitor (TKI) was changed from imatinib to dasatinib to nilotinib. The patient achieved molecular remission but became markedly short in stature, measuring 129.3 cm (height standard deviation score [SDS] −3.3) at the age of 12. TKI therapy was discontinued at age 12 years and 10 months, which was 9 years and 8 months after the start of TKI and 1 year and 6 months after achievement of MR4.0, as discontinuation before epiphyseal closure would not improve short stature. At 2 years and 6 months after discontinuation, the patient’s height improved to 156.1 cm (SDS−2.0) without relapse. Growth suppression by TKIs is a problem in the management of pediatric CML. This case illustrates how improvement in severe short stature can be achieved by discontinuing TKI therapy before epiphyseal closure.</p>
Journal
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- Rinsho Ketsueki
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Rinsho Ketsueki 65 (3), 175-179, 2024
The Japanese Society of Hematology