Long Period of Complete Haematological and Molecular Remission of Chronic Eosinophilic Leukaemia after 6months Treatment with Imatinib

We report a 25 year old male patient who was diagnosed with chronic eosinophilic leukaemia based on clinical features of Skin rash, peripheral neuropathy of right hand, malaise, and hepatosplenamegaly detectable by clinical examination His blood contained 30 × 10⁹/L Eosinophils.. A bone marrow was heavily replaced by eosinophils and eosinophil precursors. ANCA was negartive and normal Ig E levels. PCR for the PDGFR-FIP1L1 fusion gene was positive. He was initially treated with a combination of corticosteroids and alpha Interferon-2alpha and anticoagulated. At 5 months of therapy complete haematological remission had not been achieved. He was started on Imatinib mesylate 400mg per day and rapidly achieved haematological and molecular remission. Imatanib was stopped at 6 months for liver dysfunction. He was rechallenged with 100mg of imatanib after four weeks without treatment. He again developed hepatic dysfunction and imatanib was ceased completely. He remains in complete haematological and molecular remission 2 years after ceasing imatanib. He has normal performance status. This demonstrates that patients with chronic eosinophilic leukaemia who are treated with a 400mg dose of imatanib for six months may be cured or have substantial remissions. It is unclear whether the use of corticosteroids and interferon prior to the introduction of imatanib influenced the outcome. Previous published data showed that using lower doses of Imatanib does not lead to sustained remission of chronic eosinophilic leukaemia after completing drug therapy.