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Phase II open label trial of imatinib in polycythemia rubra vera

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Abstract

Polycythemia rubra vera is a chronic myeloproliferative disorder characterized by panmyelosis with the resultant potential for thrombosis, myelofibrosis, and acute leukemia. Treatment has rested on phlebotomy and hydroxyurea. In 2002, we reported two patients who were unable to tolerate hydroxyurea but responded to imatinib mesylate (Gleevec). These patients have remained in complete hematologic remission on imatinib since 1999. As a result we began a phase II, open label trial of imatinib in patients with polycythemia vera. Patients meeting the Polycythemia Vera Study group criteria for the diagnosis of polycythemia vera, either naïve or intolerant to prior treatment were allowed to enroll. Initial therapy was begun with imatinib mesylate at 400 mg a day and two dose escalations, one to 600 and second to 800 mg a day, were allowed for patients not achieving a target hematocrit of 44 or less; or a platelet count of less than 600,000/mm3. Twenty patients were enrolled, 15 achieved complete hematologic remission within 12 weeks and ten remain on study. Six patients remain in remission on 400 mg a day and four on 500 mg a day. Gastrointestinal or cutaneous toxicities were primarily grade I or II. All patients were negative for bcr/abl. Imatinib mesylate is capable of producing hematologic remission in the majority of patients with polycythemia vera and provides another option for patient management, particularly in those intolerant to hydroxyurea.

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Acknowledgments

We thank Dr. Sanford Krantz and Dr. Merrill Egorin for their continued interest and support of this project. We thank Charlena White for her excellent assistance in the preparation of this manuscript. We also wish to thanks Dr. Grant Somes, Chairman of Department of Preventive Medicine, University of Tennessee Health Science Center for his assistance with the design and statistical analysis of this trial.

Author information

Authors and Affiliations

  1. The Jones Clinic, 7710 Wolf River Circle, Germantown, TN, 38138, USA

    C. Michael Jones

  2. Department of Nursing, Arkansas State University, Jonesboro, AR, 72401, USA

    Tina M. Dickinson

  3. Novartis Pharmaceuticals, 152 Division Avenue, Summit, NJ, 07901, USA

    August Salvado

Authors
  1. C. Michael Jones
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  2. Tina M. Dickinson
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  3. August Salvado
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Corresponding authors

Correspondence to C. Michael Jones, Tina M. Dickinson or August Salvado.

Additional information

The study was performed at the Jones Clinic and the University of Pittsburg, Pittsburg Cancer Institute. We would like to thank Novartis Pharmaceuticals for providing study medications for use in this trial.

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Hematological parameters (PPT 38 kb)

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Jones, C.M., Dickinson, T.M. & Salvado, A. Phase II open label trial of imatinib in polycythemia rubra vera. Int J Hematol 88, 489–494 (2008). https://doi.org/10.1007/s12185-008-0193-1

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  • DOI: https://doi.org/10.1007/s12185-008-0193-1

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