Table 4.

Complete responses to dasatinib

SM
AMLHES
SM-PMFSM-CEL
Patient characteristics61-y-old white male, diagnosed with SM-PMF in 6/200564-y-old African-American male, diagnosed with SM-CEL in 9/200580-y-old white male, diagnosed with AML in 11/200548-y-old white female, diagnosed with HES in 1/2001
Anemia, SOB, fatigue, back painAnemia, SOB, fatigue, low-grade fever, sweating, loss of weightRash, SOB, diarrhea, fatigue
Prior therapyDarbepoetin × 5 mo without resultEpoetin alfa × 4 mo without resultDaunorubicin + cytarabine with short complete response (1 mo)Prednisone, imatinib, hydroxyurea
Baseline laboratory valuesHb: 9.4 g/dLHb: 9.4 g/dLHb: 11.8 g/dLHb 13.3 g/dL
Platelets: 90 × 109/LPlatelets: 150 × 109/LPlatelets: 604 × 109/LPlatelets: 299 × 109/L
WBC: 4.4 × 109/LWBC: 8.3 × 109/LWBC: 6.9 × 109/LWBC: 9.4 × 109/L
6% blastsEosinophils: 13%, AEC: 1.08 ×109/LNo blastsEosinophils: 28%, AEC: 2.63 × 109/L
Tryptase 22 ng/mLTryptase 13 ng/mL
Baseline BM, cytogenetics, and gene analysis4% blasts20% eosinophils13% blasts20% eosinophils
10-15% MC on biopsy10-20% MC on biopsy; insufficient metaphases on cytogenetic analysis, but t(5;12) (q33;q13) after 1 y of therapyCytogenetics: +8 [2/20]Diploid cytogenetics
Reticulin 2+ (scale 0-3)KIT-D816V negative, PDGFRα negative, JAK2-V617F negativeKIT-D816V negative, PDGFRα negative
Cytogenetics: 47, ×Y, +1, der(1;7) (q10;p10), +9 [10/20]
KIT-D816V negative
JAK2-V617F positive
Dasatinib dose70 mg twice daily70 mg twice daily; −1 level due to pleural effusion; −2 level due to fatigue70 mg twice daily; −1 level due to rash; −2 level due to rash70 mg twice daily; −1 level due to nausea/vomiting, headache and rash; stopped therapy due to pleural effusion
Response to dasatinibStarting at 3 wk:Starting at 2 mo:At 2 mo:Starting at 1 wk:
Platelets ≥148 × 109/LHb: 13.0 g/dLBM: 3% blasts≤4% eosinophils in blood
Starting at 6 mo:WBC: 7.4 × 109/LNormal cytogeneticsAt 3, 6, and 12 mo:
Hb: ≥10.1 g/dLEosinophils: 3.9%Hb: 13.7 g/dL≤4% eosinophils in BM
BM at 3 and 6 mo:BM at 3, 6, 9, 12, and 15 mo:Platelets: 223 × 109/L
HypocellularEosinophils ≤4%WBC: 6 × 109/L
No SMNo SM
Reticulin 4+Normal cellularity
Blasts 4%
OutcomeDied after 8 mo due to AMLDied off therapy (due to other medical reasons) after 18 moCytogenetic relapse after 6 mo (+8 [16/20]); AML relapse after 15 mo (BM: 10% blasts)Relapsed after 14.5 mo while off therapy
  • Abbreviations: AEC, absolute eosinophil count; MC, mast cells; SOB, shortness of breath.