Kronik Myeloid Lösemide Yeniden Kazanılan İmatinib Yanıtı: Bir Olgu Sunumu
Özet
Kronik myeloid lösemide (KML) imatinib direnci veya intoleransı durumunda ikinci basamak tirozin kinaz inhibitörlerinin (TKİ) kullanımı gündeme gelmektedir. Ancak her zaman ikinci basamak TKİ’lerinin kullanımı mümkün olmamaktadır. Burada, imatinibe dirençli bir KML olgusunda ikinci basamak tedavide kullanılan dasatinibin yan etki nedeni ile kesildikten sonra imatinibe başarılı geri dönüşü sunulmuştur. KML’de imatinibe olan direnç ikinci basamak TKİ kullanımı sonrası geriye çevirebilir ve imatinib yeniden etkili ve güvenli bir seçenek olarak düşünülebilir.
Referanslar
Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2022 update on diagnosis, therapy, and monitoring. Am J Hematol. 2022;97(9):1236–56.
Jabbour E, Kantarjian H. Chronic Myeloid Leukemia: A Review. JAMA. 2025;333(18):1618–29.
Apperley JF, Milojkovic D, Cross NC, Hjorth-Hansen H, Hochhaus A, Kantarjian H, et al. 2025 European LeukemiaNet recommendations for the management of chronic myeloid leukemia: CHRONIC MYELOID LEUKEMIA. Leukemia. 2025:1–17.
NCCN. Chronic Myeloid leukemia 2026 [Available from: https://www.nccn.org/professionals/physician_gls/pdf/cml.pdf.
Soverini S, Castagnetti F. How I evaluate and treat resistance and relapse in CML. Blood. 2026;147(4):337–46.
Noens L, Hensen M, Kucmin-Bemelmans I, Lofgren C, Gilloteau I, Vrijens B. Measurement of adherence to BCR-ABL inhibitor therapy in chronic myeloid leukemia: current situation and future challenges. Haematologica. 2014;99(3):437.
Ono T. [Key points in second-line therapy for chronic myeloid leukemia]. Rinsho Ketsueki. 2026;67(2):142–51.
Monestime S, Al Sagheer T, Tadros M. Asciminib (Scemblix): A third-line treatment option for chronic myeloid leukemia in chronic phase with or without T315I mutation. Am J Health Syst Pharm. 2023;80(2):36–43.
Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2025 update on diagnosis, therapy, and monitoring. Am J Hematol. 2024;99(11):2191–212.
Marin D, Bazeos A, Mahon F-X, Eliasson L, Milojkovic D, Bua M, et al. Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. Journal of clinical oncology. 2010;28(14):2381–8.
Eliasson L, Clifford S, Barber N, Marin D. Exploring chronic myeloid leukemia patients’ reasons for not adhering to the oral anticancer drug imatinib as prescribed. Leukemia research. 2011;35(5):626–30.
Haouala A, Widmer N, Duchosal MA, Montemurro M, Buclin T, Decosterd LA. Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib, and nilotinib. Blood, The Journal of the American Society of Hematology. 2011;117(8):e75–e87.
Go SW, Kim BK, Lee SH, Kim TJ, Huh JY, Lee JM, et al. Successful rechallenge with imatinib in a patient with chronic myeloid leukemia who previously experienced imatinib mesylate induced pneumonitis. Tuberc Respir Dis (Seoul). 2013;75(6):256–9.
Chen DH, Zhang XS. Targeted therapy: resistance and re-sensitization. Chin J Cancer. 2015;34(11):496–501.
Kuczynski EA, Sargent DJ, Grothey A, Kerbel RS. Drug rechallenge and treatment beyond progression--implications for drug resistance. Nat Rev Clin Oncol. 2013;10(10):571–87.
Kantarjian H, Breccia M, Haddad FG, Hehlmann R, Issa GC, Malhotra H, et al. Management of chronic myeloid leukemia in 2025. Cancer. 2025;131(14):e35953.
