Successful treatment of follicular lymphoma with second-generation tyrosine kinase inhibitors administered for coexisting chronic myeloid leukemia

• Published in: International journal of hematology Vol. 107; no. 6; pp. 712 - 715
• Main Authors: Fujiwara, Shin-ichiro, Shirato, Yuya, Ikeda, Takashi, Kawaguchi, Shin-ichiro, Toda, Yumiko, Ito, Shoko, Ochi, Shin-ichi, Nagayama, Takashi, Mashima, Kiyomi, Umino, Kento, Minakata, Daisuke, Nakano, Hirofumi, Morita, Kaoru, Yamasaki, Ryoko, Kawasaki, Yasufumi, Sugimoto, Miyuki, Ashizawa, Masahiro, Yamamoto, Chihiro, Hatano, Kaoru, Sato, Kazuya, Oh, Iekuni, Ohmine, Ken, Muroi, Kazuo, Kanda, Yoshinobu
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.06.2018; Springer Nature B.V
• Subjects: Aniline Compounds - administration & dosage; Aniline Compounds - adverse effects; B-cell lymphoma; Case Report; Chronic myeloid leukemia; Dasatinib - administration & dosage; Dasatinib - adverse effects; Drug Substitution; Fusion Proteins, bcr-abl - antagonists & inhibitors; Hematology; Humans; Hyperbilirubinemia; Imatinib; Imatinib Mesylate - administration & dosage; Imatinib Mesylate - adverse effects; Inhibitors; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - complications; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Lymphocytes B; Lymphoma; Lymphoma, Follicular - complications; Lymphoma, Follicular - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Myeloid leukemia; Nitriles - administration & dosage; Nitriles - adverse effects; Oncology; Protein Kinase Inhibitors - administration & dosage; Protein Kinase Inhibitors - adverse effects; Pyrimidines - administration & dosage; Quinolines - administration & dosage; Quinolines - adverse effects; Rituximab; Targeted cancer therapy; Therapy; Time Factors; Treatment Outcome; Tyrosine; Tyrosine kinase inhibitors; Vaccines; FL; Second-generation TKI; CML
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-017-2378-y

Tyrosine kinase inhibitors (TKIs) are standard therapy for chronic myeloid leukemia (CML). However, the effects of these agents on mature B cell lymphoma are not well known. We describe a 50-year-old man who was diagnosed with CML in the chronic phase and treated with imatinib. After 3 years of imatinib therapy that achieved a complete cytogenetic response of CML, he developed Philadelphia-negative follicular lymphoma (FL). Rituximab monotherapy induced a partial response of FL, and he subsequently achieved a major molecular response (MMR) of CML. Three years later, however, the MMR was lost, followed by the progression of FL. Imatinib was switched to nilotinib for the treatment of CML, while we chose watchful waiting for FL. He achieved MMR again under treatment with nilotinib for 8 months including one month of substitutional use of dasatinib due to adverse events, but thereafter nilotinib was switched to bosutinib due to hyperbilirubinemia. With the administration of second-generation TKIs (2G-TKIs) for a total of 18 months, he achieved a complete response to FL without antilymphoma treatment. This is the first report to suggest that 2G-TKIs may have direct or indirect effects on FL.