Summary
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by a reciprocal translocation between chromosomes 9 and 22. Imatinib mesylate is a potent and selective inhibitory of the BCR/ABL tyrosine kinase. Imatinib is a first choice of treatment of chronic phase CML. It has also shown activity in patients with CML in accelerated or blastic phases. However, the penetration of the drug and its active metabolites into the central nervous system (CNS) is poor. Therefore, the CNS is sanctuary site for malignant cells in patients treated with imatinib. Herein, we report a patient with CML in accelerated phase that developed central nervous system disease while on imatinib mesylate therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sawyers CL (1999) Chronic myeloid leukemia. N Engl J Med 340:1330–1340
Deininger MW, Goldman JM, Melo JW (2000) The molecular biology of chronic myeloid leukemia. Blood 96:3343–3356
Kantarjian HM, Keating MJ, Talpaz M et al (1987) Chronic myelogenous leukemia in blast crisis: analysis of 242 patients. Am J Med 83:445–454
Cervantes F, Rozman M, Rosell J, Urbano-Ispizua A, Montserrat E, Rozman C (1990) A study of prognostic factors in blast crisis of Philadelphia chromosome-positive chronic myelogenous leukemia. Br J Haematol 76:27–32
Nadal E, Olavarria E (2004) Imatinib mesylate (Gleevec/Glivec) a molecular-targeted therapy for chronic myeloid leukemia and other malignancies. J Clin Pract 58:511–516
Saikia TK, Dhabhar B, Iyer RS et al (1993) High incidence of meningeal leukemia in lymphoid blast crisis of chronic myeloid leukemia. Am J Hematol 43:10–13
Naito K, Mori T, Miyazaki K, Tsukada Y, Ikeda Y, Okamato S (2003) Successful treatment of extramedullary blast crisis of chronic myelogenous leukemia with imatinib mesylate (STI571). Intern Med 42:740–742
Rytting M, Wierda WG (2004) Central nervous system relapse in two patients with chronic myelogenous leukemia in myeloid blastic phase on imatinib mesylate therapy. Leuk Lymphoma 45:1623–1626
Pfeifer H, Wassmann B, Hofmann WK et al (2003) Risk and prognosis of central nervous system leukemia with Philadelphia chromosome-positive acute leukemias treated with imatinib mesylate. Clin Cancer Res 9:4674–4681
Talpaz M, Silver RT, Druker BJ et al (2002) Imatinib induces durable hematologic andcytogenetic responses in patients with accelerated phase chronic myeloid leukemia: result of phase 2 study. Blood 99:1928–1937
Bornhauser M, Jenke A, Freiberg-Richter J et al (2004) 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
Dai H, Marbach P, Lemaire M, Hayes M, Elmquist W (2003) Distribution of STI-571 to the brain is limited by P-glycoprotein-mediated efflux. J Pharmacol Exp Ther 304:1085–1092
Takayama N, Sato N, O’Brien SG, Ikeda Y, Okamoto SI (2002) Imatinib mesylate has a limited activity against the central nervous system involvement of Philadelphia-chromosome-positive acute lymphoblastic leukaemia due to poor penetration into cerebrospinal fluid. Br J Haematol 119:106–108
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Altintas, A., Cil, T., Kilinc, I. et al. Central nervous system blastic crisis in chronic myeloid leukemia on imatinib mesylate therapy: a case report. J Neurooncol 84, 103–105 (2007). https://doi.org/10.1007/s11060-007-9352-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-007-9352-0