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Successful treatment of a chronic-phase T-315I-mutated chronic myelogenous leukemia patient with a combination of imatinib and interferon-alfa

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Abstract

The T315I BCR-ABL mutation in chronic myelogenous leukemia (CML) patients is responsible for up to 20% of all clinically observed resistance. This mutation confers resistance not only to imatinib, but also to second-generation BCR-ABL tyrosine kinases, such as nilotinib and dasatinib. A number of strategies have been implemented to overcome this resistance, but allogeneic stem cell transplantation remains the only established therapeutic option for a cure. A 61-year-old male was diagnosed with Philadelphia chromosome-positive chronic-phase CML in 2002. He was initially treated with imatinib and complete cytogenetic response (CCyR) was achieved 12 months later. However, after 18 months, a loss of CCyR was observed and a molecular study at 24 months revealed a T315I mutation of the BCR-ABL gene. At 30 months, imatinib/interferon-alfa (IFNα) combination therapy was initiated in an effort to overcome the resistance. Thirty months later, he re-achieved CCyR, and the T315I BCR-ABL mutation disappeared at 51 months. To our knowledge, this is the first case report showing the effectiveness of imatinib/IFNα combination therapy for CML patients bearing the T315I BCR-ABL mutation.

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Authors and Affiliations

  1. Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

    Hidehiro Itonaga & Yasushi Miyazaki

  2. Department of Hematology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Hideki Tsushima, Tomoko Hata, Daisuke Imanishi, Yoshitaka Imaizumi & Takuya Fukushima

  3. Department of Internal Medicine, Nagasaki National Medical Center, Ohmura, Nagasaki, Japan

    Emi Matsuo

  4. Department of Hematology, Nagasaki Municipal Medical Center, Nagasaki, Nagasaki, Japan

    Yasuhisa Kawaguchi

  5. Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

    Yuko Doi, Sayaka Mori & Shimeru Kamihira

  6. Department of Hematology, Japanese Red-Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Nagasaki, Japan

    Masao Tomonaga

Authors
  1. Hidehiro Itonaga
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  2. Hideki Tsushima
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  3. Tomoko Hata
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  4. Emi Matsuo
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  5. Daisuke Imanishi
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  6. Yoshitaka Imaizumi
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  7. Yasuhisa Kawaguchi
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  8. Takuya Fukushima
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  9. Yuko Doi
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  11. Shimeru Kamihira
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  12. Masao Tomonaga
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  13. Yasushi Miyazaki
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Corresponding author

Correspondence to Hideki Tsushima.

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Itonaga, H., Tsushima, H., Hata, T. et al. Successful treatment of a chronic-phase T-315I-mutated chronic myelogenous leukemia patient with a combination of imatinib and interferon-alfa. Int J Hematol 95, 209–213 (2012). https://doi.org/10.1007/s12185-012-1005-1

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  • DOI: https://doi.org/10.1007/s12185-012-1005-1

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