NOTICIAS DIARIAS

Dasatinib, Standard Treatment for Paediatrics with CML-CP

Anaesthesiology

A research presented at the 22nd Congress of European Hematology Association (EHA 2017) stated that outcomes of a phase II trial indicated positive responses to dasatinib in patients with imatinib-resistant/intolerant or newly diagnosed chronic myeloid leukaemia in chronic phase (CML-CP).

Dasatinib was administered to nonrandomized prospective trial of 130 children with imatinib-resistant/intolerant (tablets; 60 mg/m2 dose; once/day) or newly diagnosed CML-CP (the same dose or the liquid formulation; 72 mg/m2; once/day). Imatinib-resistant/intolerant CML-CP children showed a significant cytogenetic response > 30 % in 12 weeks whereas newly diagnosed CML-CP children showed a cumulative rate of complete cytogenetic response     >55 % in 24 weeks.

It was estimated that at 4 years progression-free survival (PFS) rate was 78 % for imatinib-resistant/intolerant CML-CP and 93 % for newly diagnosed CML-CP.

The study reported that there were no effects on bone growth and development and epiphyses delayed fusion or osteopenia were not found. About 10 % of children showed minor adverse effects such as nausea, vomiting, myalgia, arthralgia and fatigue, similar as found in adults.

Dr Michael Zwaan from the Department of Paediatric Oncology/Haematology reported, “This is the largest ongoing, prospective trial of paediatric patients with CML-CP and we found that dasatinib was safe and effective as first- or second-line therapy in children.” The data suggests Dasatinib’s use ineffective treatment to paediatrics with CML-CP, he added.

Dasatinib’s safety and efficacy profiles in paediatrics with imatinib-pretreated CML were compared positively with those in adults. 82 % adults showed complete cytogenetic response and 47 % adults showed major molecular response. It had been shown that Dasatinib was effective for adults with imatinib-resistant/intolerant CML-CP or newly diagnosed disease.

Adults with CML treated with hydroxycarbamide or interferon-alpha (IFN-α) had a 10-year survival rate of 5 %, in the pre-tyrosine kinase inhibitor (TKI) time.

Treatment using imatinib (TKIs) against BCR-ABL (the fusion gene characteristic of CML) reported to be potent. Nowadays, imatinib is the preferable treatment for patients with CML. But, imatinib treatment showed around 30 % of intolerance or resistance to it.