Rapid and sustained molecular response to nilotinib in a patient with sub-optimal response to imatinib

Abstract

We describe here the case of a 40-years-old woman diagnosed as having chronic phase chronic myeloid leukemia and treated with standard dose of imatinib; the patient obtained the complete cytogenetic remission in 7 months, but she failed to achieve major molecular response (MMolR) after more than18 months of imatinib therapy. Sub-optimal response, defined according European LeukemiaNet guidelines, persisted despite of increasing imatinib dose to 600 mg daily. No BCR-ABL mutations were detected. Three months after switching to nilotinib 800 mg bid, the patient obtained MMolR. She experienced any toxicities due to nilotinib. We speculate about use of nilotinib in patients classified as sub-optimal at 18 months from imatinib.

Related Papers

• → OCT-1–mediated influx is a key determinant of the intracellular uptake of imatinib but not nilotinib (AMN107): reduced OCT-1 activity is the cause of low in vitro sensitivity to imatinib(2006)431 cited
• → Second-Generation Tyrosine Kinase Inhibitors: The Future of Frontline CML Therapy(2011)55 cited
• → Development and targeted use of nilotinib in chronic myeloid leukemia(2008)23 cited
• → Rapid and sustained molecular response to nilotinib in a patient with sub-optimal response to imatinib(2015)
• → Comparison of Response to Treatment with Imatinib Versus Nilotinib in the Initial Three Months in Chronic Myeloid Leukaemia(2021)