The Open Leukemia Journal

2009, 2 : 7-10
Published online 2009 February 20. DOI: 10.2174/1876816400902010007
Publisher ID: TOLEUKEMIAJ-2-7

RESEARCH ARTICLE
 Adding Hydroxyurea to Imatinib is Effective in Patients with Chronic My-elogenous Leukemia Resistant to Imatinib Alone

Roberto Latagliata, * , Massimo Breccia , Ida Carmosino , Paola Volpicelli , Rosa De Cuia , Laura Napoleone , Federico Vozella , Franco Mandelli and Giuliana Alimena
Dipartimento di Biotecnologie Cellulari ed Ematologia, University “La Sapienza” of Rome, Italy

* Address correspondence to this author at the Cattedra di Ematologia, Via Benevento 6-00161, Rome, Italy; Tel: 0039-06-857951; Fax: 0039-06-44241984; E-mail: rob.lati@libero.it

ABSTRACT

From 11/02 to 11/03, 11 patients in chronic phase (6 males and 5 females, median age 52.9 years, range 29.9-67.9 years) with persistance of >66% Ph+ cells after both standard and increased dose of Imatinib alone, were considered resistant and added Hydroxyurea (HU) to Imatinib. Seven patients were pretreated with IFN before Imatinib, median times from diagnosis and from Imatinib treatment to HU addition were 51 months (range 23-151) and 13 months (range 9-31), respectively. Four patients achieved. Complete Cytogenetic Response (CCR) after 3, 7, 12 and 32 months and 2 patients achieved a Major Cytogenetic Response (MCR) after 3 and 7 months, the remaining 5 patients were resistant, with persistence of Ph+ 100%. One patient in CCR achieved also Complete Molecular Response (CMolR) and is still responsive after 23 months. The other 3 patients in CCR as well as the 2 patients in MCR relapsed after 4, 4, 4, 10 and 12 months. In conclusion, this study provides the 1st in vivo evidence of an additive activity of HU and Imatinib; this association seems capable to induce cytogenetic response in at least one third of patients resistant to Imatinib alone, with minimal toxicity: a longer follow-up and a comparison with other associations is needed to evaluate the quality and duration of such response.

Keywords:

Chronic myelogenous leukemia, imatinib resistance, hydroxyurea.