• Wendy Deenik, Bronno van der Holt, Gregor E G Verhoef, Willem M Smit, Marie J Kersten, Hanneke C Kluin-Nelemans, Leo F Verdonck, Augustin Ferrant, Anton V M B Schattenberg, Jeroen J W M Janssen, Pieter Sonneveld, Marinus van Marwijk Kooy, Shulamit Wittebol, Roelof Willemze, Pierre W Wijermans, Petra H M Westveer, H Berna Beverloo, Peter Valk, Bob Löwenberg, Gert J Ossenkoppele, and Jan J Cornelissen.
• Department of Hematology, Erasmus University Medical Center, Groene Hilledijk 301, Rotterdam, The Netherlands.
• Blood. 2008 Mar 1; 111 (5): 2581-8.

AbstractThe HOVON cooperative study group performed a feasibility study of escalated imatinib and intravenous cytarabine in 165 patients with early chronic-phase chronic myeloid leukemia (CML). Patients received 2 cycles of intravenous cytarabine (200 mg/m(2) or 1000 mg/m(2) days 1-7) in conjunction with imatinib (200 mg, 400 mg, 600 mg, or 800 mg), according to predefined, successive dose levels. All dose levels proved feasible. Seven dose-limiting toxicities (DLTs) were observed in 302 cycles of chemotherapy, which were caused by streptococcal bacteremia in 5 cases. Intermediate-dose cytarabine (1000 mg/m(2)) prolonged time to neutrophil recovery and platelet recovery compared with a standard dose (200 mg/m(2)). High-dose imatinib (600 mg or 800 mg) extended the time to platelet recovery compared with a standard dose (400 mg). More infectious complications common toxicity criteria (CTC) grade 3 or 4 were observed after intermediate-dose cytarabine compared with a standard-dose of cytarabine. Early response data after combination therapy included a complete cytogenetic response in 48% and a major molecular response in 30% of patients, which increased to 46% major molecular responses at 1 year, including 13% complete molecular responses. We conclude that combination therapy of escalating dosages of imatinib and cytarabine is feasible. This study was registered at www.kankerbestrijding.nl as no. CKTO-2001-03.

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