Dramatic resolution of respiratory symptoms with imatinib mesylate in patients with chronic myeloid leukemia presenting with lower airway symptoms resembling asthma

Ramanujam, Deivasikamani; McNicholl, Feargal; Furby, Darshayani; Richardson, Deborah; Cuthbert, R. J. G.; McMullin, Mary Frances

doi:10.1080/10428190903161059

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…53 A small minority of patients need to restart TKI for uncontrolled discomfort. Several mechanisms have been proposed to explain this phenomenon, including activation of other kinase-mediated pathways which had been inhibited by the TKI, such as release of c-kit inhibition, 55 mast cell activation, 56 or bone remodeling effects, 57 but none has been proven yet.…”

Section: Side Effects Of Discontinuationmentioning

confidence: 99%

Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: when and for whom?

Atallah

Schiffer

2020

haematol

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Treatment discontinuation is considered one of the main goals of therapy for patients with chronic myeloid leukemia. Several criteria are felt to be necessary to consider discontinuation, while others may predict a better chance of achieving treatment-free remission. Criteria for discontinuation include patients in chronic phase chronic myeloid leukemia, a minimum duration of tyrosine kinase inhibitor therapy of 3 years, sustained deep molecular response for at least 2 years and a molecular response of at least MR4. In addition, proper education of the patient on the need for more frequent monitoring, possible side effects related to stopping and having a reliable real-time quantitative polymerase chain reaction laboratory are paramount to the safety and success of treatment-free remission. Realistically though, a maximum of only 20-30% of newly diagnosed patients will be able to achieve a successful treatment-free remission. In this article we will review for whom and when a trial of discontinuation should be considered.

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Section: Side Effects Of Discontinuationmentioning

confidence: 99%

Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: when and for whom?

Atallah

Schiffer

2020

haematol

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“…While promoting myelogenesis and thus cancer in CML, leukotrienes are key mediators of asthma pathogenesis being potent bronchoconstrictors and inflammatory agents . Combining this information, in two patients with CML also having asthma‐like lower airway symptoms, patients treated with imatinib to treat their cancer exhibited dramatic resolution of airway symptoms, suggesting targeted effects for asthma . In another case report, a 42‐year‐old man with hypereosinophilic syndrome not responding to inhaled corticosteroid or leukotriene receptor antagonists successfully responded to imatinib treatment .…”

Section: Myeloid‐modulating Agentsmentioning

confidence: 96%

Drug repurposing to treat asthma and allergic disorders: Progress and prospects

Kruse

Vanijcharoenkarn

2017

Allergy

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“…Restarting TKIs may be required in a very small number of patients who require long-term steroids or narcotics. The mechanism for the musculoskeletal pain remains unclear although several theories including release of c-Kit inhibition [32], mast cell activation [33], and bone remodeling effects [34] have been suggested. Another side effect is increased anxiety after discontinuation.…”

Section: Side Effects Of Discontinuationmentioning

confidence: 99%

Treatment-Free Remission: the New Goal in CML Therapy

Atallah

Sweet

2021

Curr Hematol Malig Rep

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Purpose of Review Treatment-free remission (TFR) is considered one of the main goals of therapy in patients with CML. Our goal in this paper is to review the current data on TFR, and discuss future directions.Recent Findings Multiple studies have demonstrated that attempting a treatment-free remission is safe and effective in a select group of patients. More recent data suggested that undetectable BCR-ABL1 by digital PCR prior to discontinuation is highly predictive of successful TFR. However, some patients have a successful TFR with no evidence of clinical disease despite persistent detectable BCR-ABL1. Some recent studies have shed some more light on possible mechanisms for this phenomena. Some possible mechanisms include immune mechanism, BCR-ABL1 detected in the lymphoid component only, or stem cell exhaustion. Summary TFR should be discussed with patients with CML. Patients who achieve a sustained deep molecular response may be eligible to attempt TFR, however, setting expectations that overall only 20% of patients with newly diagnosed CML will achieve a successful TFR. The importance of compliance to treatment early on cannot be overemphasized. Further studies using other drugs to get patients to a deeper remission in order to be eligible for TFR attempt, or attempting a second TFR in patients who had disease recurrence after first TFR attempt, are currently underway. Keywords CML • Tyrosine kinase inhibitors • Treatment-free remission • Digital PCRThis article is part of Topical Collection on Chronic Myeloid Leukemias

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Dramatic resolution of respiratory symptoms with imatinib mesylate in patients with chronic myeloid leukemia presenting with lower airway symptoms resembling asthma

Cited by 9 publications

References 4 publications

Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: when and for whom?

Discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia: when and for whom?

Drug repurposing to treat asthma and allergic disorders: Progress and prospects

Treatment-Free Remission: the New Goal in CML Therapy

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