Treatment-free molecular remission achieved by combination therapy with imatinib and IFNα in CML with BIM deletion polymorphism relapsed after stop imatinib

• Published in: Rinshō ketsueki Vol. 56; no. 2; p. 216
• Main Authors: Katagiri, Seiichiro, Tauchi, Tetsuzo, Umezu, Tomohiro, Saito, Yuu, Suguro, Tamiko, Asano, Michiyo, Yoshizawa, Seiichiro, Kitahara, Toshihiko, Akahane, Daigo, Tanaka, Yuko, Fujimoto, Hiroaki, Okabe, Seiichi, Gotoh, Moritaka, Ito, Yoshikazu, Ohyashiki, Junko H, Ohyashiki, Kazuma
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.02.2015
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Apoptosis Regulatory Proteins - genetics; Bcl-2-Like Protein 11; Benzamides - administration & dosage; Combined Modality Therapy; Gene Deletion; Humans; Imatinib Mesylate; Interferon-alpha - administration & dosage; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - diagnosis; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Male; Membrane Proteins - genetics; Middle Aged; Piperazines - administration & dosage; Polymorphism, Genetic; Proto-Oncogene Proteins - genetics; Pyrimidines - administration & dosage; Recurrence; Remission Induction - methods
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.56.216

A 51-year-old man with chronic myeloid leukemia (CML) was treated with imatinib (IM). After 24 months of treatment, he achieved a complete molecular response (CMR), which he sustained for 3 years. However, 4 months after discontinuing IM treatment, the CML relapsed. The patient was treated again with IM and achieved CMR. A combination of IM and interferon-α (IFNα) was administered for the following year, and then discontinued. The patient has since sustained CMR without therapy for 24 months, to date. This patient was found to have a BCL2L11 (BIM) deletion polymorphism. CML patients with a BIM deletion polymorphism show a low response to IM, and we infer that the BIM deletion polymorphism is a negative factor for discontinuation of IM. IFNα treatment is expected to prevent relapse during immunological surveillance. Therefore, the combination of IM and IFNα might be a feasible approach for CML patients who experience difficulty with IM discontinuation.