Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Oncology Letters
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-1074 Online ISSN: 1792-1082
Journal Cover
April-2015 Volume 9 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
April-2015 Volume 9 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Case Report

Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report

  • Authors:
    • Shiue‑Wei Lai
    • Tzu‑Chuan Huang
    • Jia‑Hong Chen
    • Yi‑Ying Wu
    • Ping‑Ying Chang
  • View Affiliations / Copyright

    Affiliations: Department of Internal Medicine, Division of Hematology and Oncology, Tri‑Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
  • Pages: 1957-1961
    |
    Published online on: February 3, 2015
       https://doi.org/10.3892/ol.2015.2928
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

BCR‑ABL tyrosine‑kinase inhibitors are the first‑line therapy for the majority of patients with chronic myelogenous leukemia (CML). Up to 20% of patients who have imatinib‑treated CML in blast crisis (BC) experience a relapse in the central nervous system (CNS) due to the poor penetration of the drug by the blood‑brain barrier. The present case reports a successful experience of using dasatinib‑based combination therapy to treat a 22‑year‑old female who presented with initial symptoms of intermittent fever and easy bruising under the diagnosis of CML in BC. Although the patient eventually succumbed to profound sepsis, the CNS involvement was treated successfully using dasatinib-based combination therapy (cranial radiation and de-escalated intrathecal chemotherapy). This case demonstrates that dasatinib may be a viable option for those who are not medically fit for or are otherwise unwilling to receive high‑dose chemotherapy. It appears that dose intensity is essential for optimal efficacy and should be maintained at 150 mg daily as far as possible.
View Figures

Figure 1

Figure 2

Figure 3

View References

1 

Schiffer CA: BCR-ABl tyrosine kinase inhibitors for chronic myelogenous leukemia. N Engl J Med. 357:258–265. 2007. View Article : Google Scholar : PubMed/NCBI

2 

Carella AM, Branford S, Deininger M, et al: What challenges remain in chronic myeloid leukemia research? Haematologica. 98:1168–1172. 2013. View Article : Google Scholar : PubMed/NCBI

3 

Pfeifer H, Wassmann B, Hofmann WK, et al: Risk and prognosis of central nervous system leukemia in patients with Philadelphia chromosome-positive acute leukemias treated with imatinib mesylate. Clin Cancer Res. 9:4674–4681. 2003.PubMed/NCBI

4 

Leis JF, Stepan DE, Curtin PT, et al: Central nervous system failure in patients with chronic myelogenous leukemia lymphoid blast crisis and Philadelphia chromosome positive acute lymphoblastic leukemia treated with imatinib (STI-571). Leuk Lymphoma. 45:695–698. 2004. View Article : Google Scholar : PubMed/NCBI

5 

Wolff NC, Richardson JA, Egorin M and Ilaria RL Jr: The CNS is a sanctuary for leukemic cells in mice receiving imatinib mesylate for Bcr/Abl-induced leukemia. Blood. 101:5010–5013. 2003. View Article : Google Scholar : PubMed/NCBI

6 

Petzer AL, Gunsilius E, Hayes M, et al: Low concentrations of STI571 in the cerebrospinal fluid: a case report. Br J Haematol. 117:623–625. 2002. View Article : Google Scholar : PubMed/NCBI

7 

Bornhauser M, Jenke A, Freiberg-Richter J, et al: CNS blast crisis of chronic myelogenous leukemia in a patient with a major cytogenetic response in bone marrow associated with low levels of imatinib mesylate and its N-desmethylated metabolite in cerebral spinal fluid. Ann Hematol. 83:401–402. 2004. View Article : Google Scholar

8 

Dai H, Marbach P, Lemaire M, Hayes M and Elmquist WF: Distribution of STI-571 to the brain is limited by p-glycoprotein-mediated efflux. J Pharmacol Exp Ther. 304:1085–1092. 2003. View Article : Google Scholar : PubMed/NCBI

9 

Bujassoum S, Rifkind J and Lipton JH: Isolated central nervous system relapse in lymphoid blast crisis chronic myeloid leukemia and acute lymphoblastic leukemia in patients on imatinib therapy. Leuk Lymphoma. 45:401–403. 2004. View Article : Google Scholar : PubMed/NCBI

10 

Isobe Y, Sugimoto K, Masuda A, Hamano Y and Oshimi K: Central nervous system is a sanctuary site for chronic myelogenous leukaemia treated with imatinib mesylate. Intern Med J. 39:408–411. 2009. View Article : Google Scholar : PubMed/NCBI

11 

Hochhaus A, Kantarjian HM, Baccarani M, et al: Dasatinib induces notable hematologic and cytogenetic responses in chronic-phase chronic myeloid leukemia after failure of imatinib therapy. Blood. 109:2303–2309. 2007. View Article : Google Scholar

12 

Kantarjian HM, Giles F, Gattermann N, et al: Nilotinib (formerly AMN107), a highly selective BCR-ABL tyrosine kinase inhibitor, is effective in patients with Philadelphia chromosome-positive chronic myelogenous leukemia in chronic phase following imatinib resistance and intolerance. Blood. 110:3540–3546. 2007. View Article : Google Scholar : PubMed/NCBI

13 

Kantarjian H, Shah NP, Hochhaus A, et al: Dasatinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 362:2260–2270. 2010. View Article : Google Scholar : PubMed/NCBI

14 

Saglio G, Kim DW, Issaragrisil S, et al: Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med. 362:2251–2259. 2010. View Article : Google Scholar : PubMed/NCBI

15 

Porkka K, Koskenvesa P, Lundan T, et al: Dasatinib crosses the blood-brain barrier and is an efficient therapy for central nervous system Philadelphia chromosome-positive leukemia. Blood. 112:1005–1012. 2008. View Article : Google Scholar : PubMed/NCBI

16 

Abdelhalim A, Barcos M, Block AW, et al: Remission of Philadelphia chromosome-positive central nervous system leukemia after dasatinib therapy. Leuk Lymphoma. 48:1053–1056. 2007. View Article : Google Scholar : PubMed/NCBI

17 

Alimena G, Breccia M, Latagliata R, et al: Dasatinib in the management of lymphoid blast crisis of Philadelphia-positive chronic myeloid leukemia with multiple extra-medullary and intracranial localizations. Leuk Res. 33:e134–e136. 2009. View Article : Google Scholar : PubMed/NCBI

18 

Nishimoto M, Nakamae H, Koh KR, et al: Dasatinib maintenance therapy after allogeneic hematopoietic stem cell transplantation for an isolated central nervous system blast crisis in chronic myelogenous leukemia. Acta Haematol. 130:111–114. 2013. View Article : Google Scholar : PubMed/NCBI

19 

Gutierrez-Aguirre H, Garcia-Rodriguez F, Cantu-Rodriguez O, Gonzalez-Llano O, Jaime-Perez J and Gomez-Almaguer D: Effectiveness of dasatinib in relapsed CNS, Ph+ ALL that is refractory to radiochemotherapy plus imatinib: a case report. Clin Adv Hematol Oncol. 9:875–878. 2011.

20 

Papageorgiou SG, Pappa V, Economopoulou C, et al: Dasatinib induces long-term remission in imatinib-resistant Philadelphia chromosome-positive acute megakaryoblastic leukemia but fails to prevent development of central nervous system progression. Leuk Res. 34:e254–e256. 2010. View Article : Google Scholar : PubMed/NCBI

21 

Frigeri F, Arcamone M, Luciano L, Di Francia R, Pane F and Pinto A: Systemic dasatinib fails to prevent development of central nervous system progression in a patient with BCR-ABL unmutated Philadelphia chromosome-positive leukemia. Blood. 113:5028–5029. 2009. View Article : Google Scholar : PubMed/NCBI

22 

Cortes J: Central nervous system involvement in adult acute lymphocytic leukemia. Hematol Oncol Clin North Am. 15:145–162. 2001. View Article : Google Scholar : PubMed/NCBI

23 

O’Hare T, Walters DK, Stoffregen EP, et al: In vitro activity of Bcr-Abl inhibitors AMN107 and BMS-354825 against clinically relevant imatinib-resistant Abl kinase domain mutants. Cancer Res. 65:4500–4505. 2005. View Article : Google Scholar

24 

Shah NP, Tran C, Lee FY, Chen P, Norris D and Sawyers CL: Overriding imatinib resistance with a novel ABL kinase inhibitor. Science. 305:399–401. 2004. View Article : Google Scholar : PubMed/NCBI

25 

McCormack PL and Keam SJ: Dasatinib: a review of its use in the treatment of chronic myeloid leukaemia and Philadelphia chromosome-positive acute lymphoblastic leukaemia. Drugs. 71:1771–1795. 2011. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Lai SW, Huang TC, Chen JH, Wu YY and Chang PY: Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report. Oncol Lett 9: 1957-1961, 2015.
APA
Lai, S., Huang, T., Chen, J., Wu, Y., & Chang, P. (2015). Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report. Oncology Letters, 9, 1957-1961. https://doi.org/10.3892/ol.2015.2928
MLA
Lai, S., Huang, T., Chen, J., Wu, Y., Chang, P."Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report". Oncology Letters 9.4 (2015): 1957-1961.
Chicago
Lai, S., Huang, T., Chen, J., Wu, Y., Chang, P."Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report". Oncology Letters 9, no. 4 (2015): 1957-1961. https://doi.org/10.3892/ol.2015.2928
Copy and paste a formatted citation
x
Spandidos Publications style
Lai SW, Huang TC, Chen JH, Wu YY and Chang PY: Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report. Oncol Lett 9: 1957-1961, 2015.
APA
Lai, S., Huang, T., Chen, J., Wu, Y., & Chang, P. (2015). Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report. Oncology Letters, 9, 1957-1961. https://doi.org/10.3892/ol.2015.2928
MLA
Lai, S., Huang, T., Chen, J., Wu, Y., Chang, P."Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report". Oncology Letters 9.4 (2015): 1957-1961.
Chicago
Lai, S., Huang, T., Chen, J., Wu, Y., Chang, P."Dasatinib as the salvage therapy for chronic myeloid leukemia with blast crisis and central nervous system involvement: A case report". Oncology Letters 9, no. 4 (2015): 1957-1961. https://doi.org/10.3892/ol.2015.2928
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team