Characteristics of patients with development of large granular lymphocyte expansion among dasatinib-treated patients with relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia after allogeneic stem cell transplantation

Yoshikiyo Ito, Toshihiro Miyamoto, Tomohiko Kamimura, Kenichi Aoki, Hideho Henzan, Takatoshi Aoki, Motoaki Shiratsuchi, Koji Kato, Koji Nagafuji, Ryosuke Ogawa, Tetsuya Eto, Hiromi Iwasaki, Koichi Akashi

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Introduction Widespread use of tyrosine kinase inhibitors (TKIs) in combination with chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-SCT) has totally changed the existing treatment strategies for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL). However, the prognosis after relapse after allo-SCT is still dismal. Patients and Methods We analyzed the clinical outcome of therapy using dasatinib, a second-generation TKI, in 9 patients with relapsed Ph+ALL after allo-SCT. Dasatinib was initiated at a median time of 168 days after allo-SCT at dosages ranging from 20 mg to 100 mg daily. Results Six of 9 patients manifested a marked increase in large granular lymphocytes (LGLs), but all 6 patients discontinued dasatinib because of adverse events (AEs) such as pleural effusion. Four of 6 patients resumed dasatinib, and 3 of them have been alive with molecular complete remission and a persistent increase of LGLs. Conclusion Our results demonstrated that dasatinib therapy can induce LGL expansion accompanied by AEs, but this phenomenon can be associated with long-term survival benefit in a proportion of relapsed Ph+ALL patients after allo-SCT.

Original languageEnglish
Pages (from-to)e47-e54
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

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