Dynamics and management of cytopenias associated with dasatinib therapy in patients with chronic myeloid leukemia in chronic phase after imatinib failure
Quintás-Cardama A et al. – Study reports that hematologic toxicity was frequent during dasatinib therapy in patients with chronic myeloid leukemia in chronic phase (CP CML), particularly at doses >100 mg daily. Treatment interruption and/or dose reduction as well as growth factor support were safe and efficacious strategies to facilitate the continuous administration of dasatinib. Methods- Aim was to investigate the incidence, dynamics, and management of cytopenias in ps with CP CML who received dasatinib therapy after imatinib failure
- Data were analyzed from 130 pts in phase 1 (n=22) or phase 2 or 3 (n=108) studies for grade 2 to 4 cytopenia
Results- Grade 2 to 4 neutropenia and/or thrombocytopenia occurred in 94 (72%) pts during dasatinib therapy
- Grade 3 to 4 occurred in 67 (52%) pts
- Of the 94 pts who developed grade 2 to 4 neutropenia and/or thrombocytopenia-
- 68% also developed at least grade 2 anemia, and
- 17% grade 3 to 4 anemia
- Management of cytopenias included:
- Transient dasatinib interruption in 35 (37%) pts
- Filgrastim in 12 (14%) pts
- Recombinant erythropoietin in 29 (45%) pts, and
- Interleukin-11 in 3 (5%) pts
- Factors associated with an increased risk for developing grade 2 to 4 cytopenias were:
- Longer time from diagnosis to treatment
- Prior interferon or imatinib therapy, and
- Lower white blood cell count at the initiation of dasatinib therapy
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