Annals of Hematology

, Volume 89, Issue 11, pp 1099–1105

Standard-dose imatinib plus low-dose homoharringtonine and granulocyte colony-stimulating factor is an effective induction therapy for patients with chronic myeloid leukemia in myeloid blast crisis who have failed prior single-agent therapy with imatinib

  • Baijun Fang
  • Ning Li
  • Yongping Song
  • Qin Han
  • Robert Chunhua Zhao
Original Article

Abstract

We investigated the efficacy of the induction therapy involving granulocyte colony-stimulating factor (G-CSF) and low-dose homoharringtonine as well as standard-dose imatinib, which we called the G-CSF + homoharringtonine + imatinib (GHI) regimen, in patients with chronic myelogenous leukemia (CML) in blast crisis who have failed prior single-agent therapy with imatinib. Twelve patients were enrolled. The GHI regimen consisted in a unique induction course where imatinib was administered at 400 mg day−1 until remission, together with homoharringtonine (1 mg/m2 s.c. twice daily for 14 days every 28 days), and G-CSF, which was administered 1 day before chemotherapy (5 µg/kg s.c. daily). Patients who failed to obtain at least a partial hematologic response (PHR) after three courses were taken off study. Patients who responded to induction treatment and who had a matched donor received allogeneic hematopoietic stem cell transplantation (allo-HSCT). The results demonstrates that the GHI regimen re-induce hematologic responses or improve the cytogenetic responses in all evaluable patients. Furthermore, eligible patients have benefited from allo-HSCT after response to this induction treatment. We conclude that the GHI regimen may overcome disease-poor response to conventional doses of imatinib and this approach deserves further evaluation as frontline therapy for newly diagnosed CML.

Keywords

Chronic myelogenous leukemia Blast crisis Granulocyte colony-stimulating factor Homoharringtonine Imatinib Resistant 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Baijun Fang
    • 1
  • Ning Li
    • 1
  • Yongping Song
    • 1
  • Qin Han
    • 2
  • Robert Chunhua Zhao
    • 2
  1. 1.Henan Key Lab of Experimental Haematology, Henan Institute of Haematology, Henan Tumor Hospital, Zhengzhou Medical SchoolZhengzhou UniversityZhengzhouPeople’s Republic of China
  2. 2.Institute of Haematology and Blood Diseases Hospital, Center of Excellence in Tissue EngineeringChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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