Nilotinib efficacy and safety in CML patient with Parossistic Sopraventricular Tachycardia (PSVT), after sub-optimal response to imatinib

Stefana Impera, Ugo Consoli, Giuseppina Uccello, Patrizia Guglielmo

DOI: https://doi.org/10.7175/cmi.v5i3S.1120

Abstract

Here we describe the case of a 61-year-old woman who developed chronic myeloid leukaemia in chronic phase under treatment with antiaritmic-therapy (amiodarone) for Parossistic Sopraventricular Tachycardia (PSVT). Initially the patient started with imatinib at standard dose of 400 mg/day but after 6 months of treatment she reached only a Minor Cytogenetic Response (“sub-optimal response”, according to European LeukaemiaNet criteria 2006). After 9 months, she was still in a Minor Cytogenetic Response. We therefore performed a mutation screening analysis that highlighted T240S, N322S, T406A, Y435N mutations. The patient switched to nilotinib at the dose of 800 mg day: Complete Cytogenetic Response and Major Molecular Response were reached after 3 months. Nilotinib was safely administered without further QTc prolongation or haematologic and extrahaematologic adverse side effects.

Keywords

Chronic myeloid leukemia; Nilotinib; Sub-optimal response; Parossistic Sopraventricular Tachycardia (PSVT)

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