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Dynamics and management of cytopenias associated with dasatinib therapy in patients with chronic myeloid leukemia in chronic phase after imatinib failure
Cancer, 06/15/09

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