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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2013; 34(03): 221-223
DOI: 10.4103/0971-5851.123750
ORIGINAL ARTICLE

Kinase domain mutations and responses to dose escalation in chronic myeloid leukemia resistant to standard dose imatinib mesylate

Senthil Rajappa
Nizam′s Institute of Medical Science is a Premier Institute, Hyderabad, Andhra Pradesh, India
,
Krishna Mohan Mallavarapu
Nizam′s Institute of Medical Science is a Premier Institute, Hyderabad, Andhra Pradesh, India
,
Sadashivudu Gundeti
Nizam′s Institute of Medical Science is a Premier Institute, Hyderabad, Andhra Pradesh, India
,
Tara Roshni Paul
Nizam′s Institute of Medical Science is a Premier Institute, Hyderabad, Andhra Pradesh, India
,
Rachel Thomas Jacob
Nizam′s Institute of Medical Science is a Premier Institute, Hyderabad, Andhra Pradesh, India
,
Raghunadharao Digumarti
Nizam′s Institute of Medical Science is a Premier Institute, Hyderabad, Andhra Pradesh, India
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Abstract

Imatinib has shown unprecendeted success in the treatment of chronic myeloid leukemia (CML). However, over few years there have been reports regarding the primary and secondary resistance to Imatinib dampening the overall outcome in CML patients. In this study we have tried to assess the effect of dose escalation in patients resistant to standard dose of Imatinib and correlate it with presence of ABL kinase domain (KD) mutations. There were 90 patients resistant to imatinib, out which 29 patients were identified with KD mutations. The most common mutation was T315I , 9 out of 29 patients had it. 35 (38%) responded to dose escalation and had 67% event free survival (EFS) at estimated 2 years. Our results showed that dose escalation can over come resistance in some patients especially those in cytogenetic failure.

Keywords

Chronic myeloid leukemia - imatinib - kinase domain mutations and responses


Publication History

Article published online:
19 July 2021

© 2013. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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