A single weekly dose of imatinib is sufficient to induce and maintain remission of chronic eosinophilic leukaemia in FIP1L1-PDGFRA-expressing patients

Br J Haematol. 2008 Apr;141(2):200-4. doi: 10.1111/j.1365-2141.2008.07033.x. Epub 2008 Feb 26.

Abstract

Hypereosinophilic syndrome (HES) is defined as chronic, unexplained hypereosinophilia with organ involvement. A subset of HES patients presents an interstitial deletion in chromosome 4q12, which leads to the expression of an imatinib-responsive fusion gene, FIP1L1-PDGFRA. These patients are diagnosed as chronic eosinophilic leukaemia (CEL). We treated seven CEL and HES patients, six of which expressed FIP1L1-PDGFRA, with imatinib using initial daily doses ranging from 100 to 400 mg. In a remission maintenance phase, the patients were treated with imatinib once weekly. All imatinib-treated patients achieved a complete haematological remission (CHR), and five of the six patients with FIP1L1-PDGFRA expression exhibited molecular remission. The decreased imatinib doses were as follows: 200 mg/week in three patients, 100 mg/week in two patients and 100 mg/d in the remaining two patients. For remission maintenance, imatinib doses were set at 100 mg/week in five patients and 200 mg/week in two patients. At a median follow-up of 30 months all patients remained in CHR and FIP1L1-PDGFRA expression was undetectable in five of the six FIP1L1-PDGFRA-expressing patients. These data suggest that a single weekly dose of imatinib is sufficient to maintain remission in FIP1L1-PDGFRA- positive CEL patients.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Benzamides
  • Biomarkers / blood
  • Chronic Disease
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Hypereosinophilic Syndrome / blood
  • Hypereosinophilic Syndrome / drug therapy*
  • Imatinib Mesylate
  • Male
  • Middle Aged
  • Oncogene Proteins, Fusion / blood*
  • Piperazines / administration & dosage*
  • Piperazines / therapeutic use
  • Protein Kinase Inhibitors / administration & dosage*
  • Protein Kinase Inhibitors / therapeutic use
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Pyrimidines / administration & dosage*
  • Pyrimidines / therapeutic use
  • Receptor, Platelet-Derived Growth Factor alpha / blood*
  • Remission Induction
  • Treatment Outcome
  • mRNA Cleavage and Polyadenylation Factors / blood*

Substances

  • Benzamides
  • Biomarkers
  • Oncogene Proteins, Fusion
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • mRNA Cleavage and Polyadenylation Factors
  • Imatinib Mesylate
  • FIP1L1-PDGFRA fusion protein, human
  • Protein-Tyrosine Kinases
  • Receptor, Platelet-Derived Growth Factor alpha