Safe discontinuation of nilotinib in a patient with chronic myeloid leukemia: a case report

Journal of Medical Case Reports

Giorgio La Nasa²  Marianna Greco¹  Giovanni Caocci² 

[1] Bone Marrow Transplant Center, "R Binaghi" Hospital, Via Is Guadazzonis 3, 09126 Cagliari, Italy;Hematology Unit, Department of Medical Sciences, University of Cagliari, Via Is Guadazzonis 3, 09126 Cagliari, Italy

关键词: Tyrosine kinase inhibitor discontinuation;    Nilotinib;    Killer immunoglobulin-like receptors;    Imatinib;    Chronic myeloid leukemia;   

Others  :  1181057
DOI  :  10.1186/1752-1947-8-295

 received in 2014-03-20, accepted in 2014-07-21,  发布年份 2014

【 摘 要 】

Introduction

Although there is a considerable amount of data in the literature on safe discontinuation of first-generation tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia, little is known about discontinuation of second-generation tyrosine kinase inhibitor therapy. Most previous studies have been focused on dasatinib, and the few cases of nilotinib withdrawal that have been reported had a median follow-up of 12 months. To the best of our knowledge, the present report is the first to describe nilotinib withdrawal with 30 months of follow-up.

Case presentation

We report the case of a 64-year-old Caucasian man diagnosed with chronic-phase chronic myeloid leukemia in April 2005. After 4 years of treatment with imatinib, he became intolerant to the drug and was switched to nilotinib. Two years later, he decided to stop nilotinib. Undetectable molecular response persisted for 30 months after discontinuation of the drug.

Conclusion

Our present case suggests that nilotinib withdrawal is safe for patients with chronic myeloid leukemia who achieve a stable undetectable molecular response. Our patient was homozygous for killer immunoglobulin-like receptor haplotype A, previously reported to be a promising immunogenetic marker for undetectable molecular response. We recommend additional studies to investigate patient immunogenetic profiles and their potential role in complete response to therapy.

【 授权许可】

   
2014 Caocci et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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