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Annals of hematology · Jun 2004
Case ReportsCNS 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.
- Martin Bornhauser, Andreas Jenke, Jens Freiberg-Richter, Jörgen Radke, Ulrich S Schuler, Brigitte Mohr, Gerhard Ehninger, and Eberhard Schleyer.
- Med. Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany. bornhaeuser@uniklinikum-dresden.de
- Ann. Hematol. 2004 Jun 1; 83 (6): 401-2.
AbstractImatinib mesylate (STI571) is a very effective treatment option for Ph(+) chronic myeloid leukemia (CML) in chronic phase. Secondary treatment failures have mostly been observed in patients with advanced stages of disease. We report the case of a patient who unexpectedly experienced blast crisis of the central nervous system although having achieved complete cytogenetic remission in the bone marrow. The levels of STI571 and its metabolite N-desmethyl STI were 40-fold lower in the cerebral spine fluid than in plasma. The risk of CNS disease has to be kept in mind when patients with CML in chronic phase who are at an increased risk for blastic transformation are treated with imatinib mesylate.
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