Clinical efficacy of second generation tyrosine kinase inhibitor and 5-azacytidine combination in chronic myelogenous leukaemia in myeloid blast crisis

Eur J Cancer. 2013 Nov;49(17):3666-70. doi: 10.1016/j.ejca.2013.07.147. Epub 2013 Aug 19.

Abstract

Even in the tyrosine kinase inhibitors era, the prognosis of patients with chronic myeloid leukaemia in myeloid blast crisis remains dismal with few patients surviving longer than 6 months. Here we report the cases of 5 patients treated with the combination of 5-azacytidine and tyrosine kinase inhibitors for myeloid blast crisis CML. All patients achieved a complete haematological response including two with a complete cytogenetic and major molecular response. Two patients underwent an allogeneic stem cell transplantation. One died from relapse 34 months from diagnosis. The second is alive and free from disease at 11 months from diagnosis. The other 3 patients are still in complete haematological response after 15, 24 and 33 months of follow-up. These results suggest that the combination has a significant activity in myeloid blast crisis and may increase survival.

Keywords: Blast phase; Chronic myelogenous leukaemia; Tyrosine kinase inhibitors.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Azacitidine / administration & dosage*
  • Blast Crisis / drug therapy*
  • Dasatinib
  • Female
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology*
  • Male
  • Middle Aged
  • Protein Kinase Inhibitors / administration & dosage*
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Pyrimidines / administration & dosage
  • Thiazoles / administration & dosage
  • Treatment Outcome

Substances

  • Protein Kinase Inhibitors
  • Pyrimidines
  • Thiazoles
  • Protein-Tyrosine Kinases
  • nilotinib
  • Azacitidine
  • Dasatinib