Dear Dave,

Below is the abstract of the article.  Don't worry, with time, you may
be able to go off Gleevec, especially if you have 100% donor cells.

Best Regards,
Anjana
caregiver to Roy

J Clin Oncol. 2005 Oct 20;23(30):7583-93.  Links
Sustained complete molecular remissions after treatment with
imatinib-mesylate in patients with failure after allogeneic stem cell
transplantation for chronic myelogenous leukemia: results of a
prospective phase II open-label multicenter study.Hess G, Bunjes D,
Siegert W, Schwerdtfeger R, Ledderose G, Wassmann B, Kobbe G,
Bornhauser M, Hochhaus A, Ullmann AJ, Kindler T, Haus U, Gschaidmeier
H, Huber C, Fischer T.
III. Med. Klinik, Johannes Gutenberg-University, Mainz; University of
Ulm, II. Med. Klinik, Charite, Germany.

PURPOSE: In the era of molecular therapy of chronic myelogenous
leukemia (CML) applying BCR-ABL tyrosine kinase inhibitors, the
usefulness of molecular end points, in particular, quantitative
polymerase chain reaction (PCR) for BCR-ABL in monitoring responses has
been broadly accepted. Therefore, we have designed a prospective phase
II trial in CML, which, for the first time, evaluated the feasibility
and safety of molecular end points as surrogate markers to guide
through a stratified treatment algorithm within a multicenter trial.
PATIENTS AND METHODS: As a clinical model, we adopted minimal residual
disease (MRD) found in relapse after allogeneic stem cell
transplantation (SCT) in CML. Forty-four patients were enrolled and
received the BCR-ABL tyrosine kinase inhibitor imatinib (IM) at a
starting dose of 400 mg/d. The quality of molecular responses achieved
then decided on discontinuation of IM or dose escalation up to 800
mg/d, and finally, on application of donor lymphocyte infusions.
Results Seventy percent of patients achieved a complete molecular
response (CMR), defined as nested PCR-negativity for BCR-ABL in three
consecutive samples. Interestingly, in four out of 10 patients who
discontinued IM, CMR was durable even after cessation of IM with a
median follow-up of 494 days. This suggests the possibility of
long-term tumor control in a subset of patients. CONCLUSION: The
treatment strategy showed that IM treatment was well-tolerated and
highly efficacious in MRD after allogeneic SCT. Moreover, this study
demonstrated that evaluation of a molecular end point within a
multicenter trial can be a safe and effective tool for clinical
decision making.


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