Myelosuppression in patients benefiting from imatinib with hydroxyurea for recurrent malignant gliomas

Gaurav D. Shah, Joel S. Silver, Steven S. Rosenfeld, Igor T. Gavrilovic, Lauren E. Abrey, Andrew B. Lassman

Research output: Contribution to journalArticle

9 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)217-222
Number of pages6
JournalJournal of neuro-oncology
Volume85
Issue number2
DOIs
StatePublished - Nov 1 2007

Keywords

  • Chemotherapy
  • Glioblastoma
  • Hydroxyurea
  • Imatinib
  • Myelosuppression
  • Stem cells

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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