Nilotinib after resistance to imatinib in CML patients with Wolf-Parkinson White syndrome

Abstract

We report a case of a young man affected by Wolf-Parkinson White syndrome, who was diagnosed as having chronic myeloid leukemia. He started imatinib at standard dose of 400 mg/day and he reached a partial cytogenetic response at 6 months, a sub-optimal response according to European LeukemiaNet criteria of 2006. For this reason he increased imatinib dose to 600 mg/day, but after 3 months he suddenly lost his hematologic response. Cytogenetic analysis performed at this time showed a cytogenetic relapse and acquisition of an additional cytogenetic abnormality (trisomy 8). Considering the patient as a failure at this time, he switched to second-generation tyrosine kinase inhibitor, nilotinib at the dose of 800 mg/day. He reached complete cytogenetic remission after 3 months and nilotinib was safely administered without further QTc prolongation.