Chronic myeloid leukemia following therapy with imatinib mesylate (Gleevec)

Bone marrow histopathology and correlation with genetic status

John L. Frater, Martin S. Tallman, Daina Variakojis, Brian Druker, Debra Resta, Mary Beth Riley, Mary Ann Hrisinko, Lo Ann C. Peterson

Research output: Contribution to journalArticle

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Abstract

We evaluated bone marrow pathologic features and cytogenetic and molecular genetic status of 13 patients with interferon- resistant, chronic-phase chronic myeloid leukemia (CML), treated with imatinib mesylate (Gleevec). All had morphologic evidence of CML in the blood and bone marrow and were positive for bcr-abl by reverse transcriptase-polymerase chain reaction, fluorescence in situ hybridization (FISH), or both. Follow-up marrow biopsies, interphase FISH for bcr-abl, and conventional cytogenetics were performed at 3-month intervals (up to 24 months) after therapy initiation. All patients exhibited a reduction in bone marrow cellularity with decreases in myeloid/erythroid ratios at 3 to 6 months after therapy. The percentage of bcr-abl-positive cells by FISH decreased in all patients (pretherapy median, 73%; 3 months median, 47%). Cytogenetic and FISH data defined 2 groups after 6 months of follow-up: 5 patients became negative for bcr-abl by FISH; 8 remained positive, 4 of whom developed signs of clonal cytogenetic evolution. Patients who became negative for bcr-abl had no morphologic evidence of CML at 15 to 24 months of follow-up, whereas patients who remained positive redeveloped morphologic features of CML as cellularity increased. Some bcr-abl-positive patients showed signs of progression, including 2 patients who developed myeloid blast phase. Although all patients demonstrated an initial decrease in bone marrow cellularity after imatinib mesylate therapy, continued follow-up showed that histopathologic findings correlated with genetic response.

Original languageEnglish (US)
Pages (from-to)833-841
Number of pages9
JournalAmerican Journal of Clinical Pathology
Volume119
Issue number6
DOIs
StatePublished - Jun 1 2003

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Bone Marrow
Fluorescence In Situ Hybridization
Cytogenetics
Therapeutics
Clonal Evolution
Leukemia, Myeloid, Chronic Phase
Blast Crisis
Imatinib Mesylate
Interphase
Reverse Transcriptase Polymerase Chain Reaction
Interferons
Molecular Biology
Biopsy

Keywords

  • bcr-abl
  • Chronic myeloid leukemia
  • Gleevec
  • Imatinib mesylate

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Chronic myeloid leukemia following therapy with imatinib mesylate (Gleevec) : Bone marrow histopathology and correlation with genetic status. / Frater, John L.; Tallman, Martin S.; Variakojis, Daina; Druker, Brian; Resta, Debra; Riley, Mary Beth; Hrisinko, Mary Ann; Peterson, Lo Ann C.

In: American Journal of Clinical Pathology, Vol. 119, No. 6, 01.06.2003, p. 833-841.

Research output: Contribution to journalArticle

Frater, John L. ; Tallman, Martin S. ; Variakojis, Daina ; Druker, Brian ; Resta, Debra ; Riley, Mary Beth ; Hrisinko, Mary Ann ; Peterson, Lo Ann C. / Chronic myeloid leukemia following therapy with imatinib mesylate (Gleevec) : Bone marrow histopathology and correlation with genetic status. In: American Journal of Clinical Pathology. 2003 ; Vol. 119, No. 6. pp. 833-841.
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