CNS 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 cer

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• 作者：Martin Bornhauser ; Andreas Jenke ; Jens Freiberg-Richter ; J?rgen Radke ; UlrichS. Schuler ; Brigitte Mohr ; Gerhard Ehninger and Eberhard Schleyer
• 关键词：Imatinib mesylate ; CML ; CNS involvement ; Pharmacokinetics
• 刊名：Annals of Hematology
• 出版年：2004
• 出版时间：June 2004
• 年：2004
• 卷：83
• 期：6
• 页码：401-402
• 全文大小：80 KB

文摘

Imatinib 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.