Myelosuppression in patients benefiting from imatinib with hydroxyurea for recurrent malignant gliomas Journal Article
| Authors: | Shah, G. D.; Silver, J. S.; Rosenfeld, S. S.; Gavrilovic, I. T.; Abrey, L. E.; Lassman, A. B. |
| Article Title: | Myelosuppression in patients benefiting from imatinib with hydroxyurea for recurrent malignant gliomas |
| Abstract: | Reports suggest reasonable efficacy and minimal myelosuppression from combination imatinib and hydroxyurea for recurrent malignant glioma. We retrospectively reviewed 16 patients treated with this regimen who were evaluable for toxicity; 14 were also evaluable for response. The incidence of grade 3-4 hematologic toxicity was 25%. The best radiographic response, by Macdonald criteria, was partial response (PR) in three patients (21%), stable disease (SD) in four (29%), and progressive disease (PD) in seven (50%). One patient with a PR developed therapy-limiting hematologic toxicity on day 19 of treatment, progressing to grade 4 on day 64, and persisting until death on day 127 despite discontinuing both drugs. Another patient with PR and two of four patients with SD also developed grade 3 hematologic toxicity. All patients with grade 3-4 hematologic toxicity had disease control (PR or SD) as best radiographic response, whereas none with PD suffered grade 3-4 hematologic toxicity. Combining imatinib with hydroxyurea is effective in some patients with malignant glioma. However, myelosuppression can persist for months after discontinuing the regimen, precluding further chemotherapy. Disease control may also correlate with hematologic toxicity (p = 0.08), suggesting that glioma and marrow stem cells may share a common sensitivity to this chemotherapy regimen. © Springer Science+Business Media, LLC 2007. |
| Keywords: | adult; clinical article; controlled study; treatment outcome; aged; middle aged; retrospective studies; hydroxyurea; neutropenia; bevacizumab; erlotinib; drug dose reduction; drug efficacy; drug withdrawal; treatment duration; chemotherapy; temozolomide; recurrent cancer; brain neoplasms; imatinib; unindexed drug; multiple cycle treatment; neoplasm recurrence, local; erythropoietin; anemia; bone marrow; bone marrow suppression; blood toxicity; leukopenia; thrombocytopenia; antineoplastic combined chemotherapy protocols; dexamethasone; pyrimidines; medical record review; retrospective study; carmustine; lomustine; irinotecan; drug dose escalation; protein kinase inhibitors; statistical significance; death; etiracetam; oxcarbazepine; topiramate; celecoxib; glioblastoma; drug response; gefitinib; blood transfusion; stem cells; oligodendroglioma; disease duration; pancytopenia; protein-tyrosine kinases; seizure; external beam radiotherapy; piperazines; isotretinoin; cancer control; levothyroxine; cotrimoxazole; drug sensitivity; granulocyte colony stimulating factor; astrocytoma; gliosarcoma; clonazepam; leg edema; rapamycin; lapatinib; phenytoin; enzastaurin; brain surgery; valproic acid; thrombocyte transfusion; cilengitide; carbamazepine; gabapentin; pantoprazole; nucleic acid synthesis inhibitors; bone marrow diseases; correlation function; myelosuppression |
| Journal Title: | Journal of Neuro-Oncology |
| Volume: | 85 |
| Issue: | 2 |
| ISSN: | 0167-594X |
| Publisher: | Springer |
| Date Published: | 2007-11-01 |
| Start Page: | 217 |
| End Page: | 222 |
| Language: | English |
| DOI: | 10.1007/s11060-007-9408-1 |
| PUBMED: | 17594055 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 17 November 2011" - "CODEN: JNODD" - "Source: Scopus" |
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111Lassman -
73Gavrilovic -
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