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What is the best salvage therapy for treatment of isolated CNS relapse in elderly patients with imatinib-responsive Ph+ ALL?

✍ Scribed by Giuseppe Mele; Salvatore Pinna; Angela Melpignano; Antonio Romano; Maurizio Claudio Brocca; Maria Rosaria Coppi; Giovanni Quarta


Publisher
Elsevier Science
Year
2007
Tongue
English
Weight
93 KB
Volume
31
Category
Article
ISSN
0145-2126

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✦ Synopsis


We report the case of an elderly patient affected by Philadelphia positive Acute Lymphoblastic Leukaemia (Ph(+) ALL) who developed meningeal leukaemia during imatinib monotherapy, despite bone marrow molecular remission. Aggressive central nervous system (CNS)-directed therapy in combination with continued imatinib treatment might be, at the moment, the most effective salvage therapy for imatinib-responsive elderly patients with isolated CNS relapse. In view of the inefficacy of imatinib at preventing meningeal leukaemia for its poor penetration into the CNS, CNS prophylactic therapy should always be an integral part of any imatinib-based treatment strategy for Ph(+) ALL.