Hi Saros, The study cohort is small but the second abstract gives the details of the patients, it was presented by MDACC doctors at the American Society of Hematology 2003.
Best Wishes, Anjana Leuk Res. 2004 Jun;28(6):613-8. Related Articles, Links Interleukin 11 May improve thrombocytopenia associated with imatinib mesylate therapy in chronic Myelogenous leukemia. Ault P, Kantarjian H, Welch MA, Giles F, Rios MB, Cortes J. MD Anderson Cancer Center, Department of Leukemia, The University of Texas, 1515 Holcombe Boulevard, PO Box 428, Houston, TX 77030, USA. During therapy with imatinib (Gleevec), 20-30% of patients with CML in chronic phase develop grade > or =3 thrombocytopenia. This leads to treatment interruptions and dose reductions that result in a decreased probability of achieving a cytogenetic response. Interleukin-11 (oprelvekin) is a megakaryopoietic cytokine that reduces the incidence and severity of thrombocytopenia associated with chemotherapy. We report on the use of interleukin-11 in three CML patients with grade > or =3, imatinib-induced thrombocytopenia. In all three patients, interleukin-11 led to improved platelets, uninterrupted administration of imatinib and improved cytogenetic response. This observation suggests that interleukin-11 may be beneficial for patients with imatinib-induced thrombocytoepnia. [4972] Interleukin 11 (IL-11, Neumega) May Involve the Thrombocytopenia Associated with Imatinib Therapy in Patients (pts) with Chronic Myelogenous Leukemia (CML). Session Type: Publication Only Patricia Ault, Mary Alma Welch, Francis Giles, Mary Beth Rios, Hagop Kantarjian, Jorge Cortes Leukemia, M.D. Anderson Cancer Center, Houston, TX, USA During the course of therapy with imatinib in CML cytopenias occur frequently. Grade 3 thrombocytopenia and neutropenia have been reported in 14% to 16% of the patients, respectively. These adverse events have been managed with treatment interruptions and dose reductions, and decrease the probability of responding to imatinib (Sneed, ASH 2002, Abstract #3110). IL-11 can reduce the incidence and severity of chemotherapy-associated thrombocytopenia. Lower doses have been effective in hypoplastic bone marrow conditions (Kurzrock et al, JCO 2001; 19: 4165). Herein, we report on the successful use of low-dose IL-11 in 3 patients with CML receiving imatinib therapy that were experiencing persistent and recurrent grade 3 thrombocytopenia requiring frequent interruptions and dose reductions. The first pt was a 39-year-old female receiving imatinib 400 mg daily as initial therapy for early chronic phase CML. She developed grade 3 thrombocytopenia after only 6 weeks of therapy requiring interruption of imatinib. When platelets recovered 15 days later, imatinib was re-started at 300 mg daily. Over the following 15 months, she required multiple interruptions every 3-4 weeks of therapy, with recovery taking progressively longer, up to 5 months. IL-11 was started at 10 mcg/kg 3 times and then 5 times weekly. With this she has sustained a platelet count over 60 x 109/L for 9 months without further interruptions of imatinib. Her cytogenetic response improved from minor (60% Ph+) to major (15% Ph+) during this time. The second pt was a 58-year-old female with CML in accelerated phase after IFN failure. She developed pancytopenia 4 weeks after starting imatinib 600 mg/d. Filgrastin and EPO were started with good response but residual thrombocytopenia. IL-11 was started 1 month later (10 mcg/kg/d) and 2 weeks later platelets recovered. Imatinib was re-started (400 mg/d) with recurrent thrombocytopenia. IL-11 was increased to 25 mcg/kg and when platelets recovered, imatinib was re-started at 300 mg/d. The platelet count slowly improved allowing an increase in the dose of imatinib (400 mg/d) and eventual discontinuation of IL-11. The third pt was a 54-year-old male treated with imatinib 400 mg in early CP. Grade 3 thrombocytopenia developed after 6 months and recurred multiple times during the following 12 months despite dose reductions and interruptions. IL-11 was started and imatinib re-started at 400 mg/d. There was a steady increase in the platelet count to normal levels despite increasing the dose of imatinib to 600 mg/d. With this, the cytogenetic response improved from minor (70% Ph+) to major (10% Ph+). We conclude that IL-11 is effective in managing imatinib-associated thrombocytopenia and may improve response to imatinib by reducing the need for treatment interruptions. --~--~---------~--~----~------------~-------~--~----~ [CMLHope] A support group of http://cmlhope.com ------------------------------------------------- You received this message because you are subscribed to the Google Groups "CMLHope" group. To post to this group, send email to [email protected] To unsubscribe from this group, send email to [EMAIL PROTECTED] For more options, visit this group at http://groups.google.com/group/CMLHope -~----------~----~----~----~------~----~------~--~---
