Incidence and management of myelosuppression in patients with chronic- and accelerated-phase chronic myeloid leukemia treated with omacetaxine mepesuccinate

• Type of Material: Article
• Authors: Luke Akard, St Francis Franciscan Alliance; Hagop M. Kantarjian, University of Texas MD Anderson Cancer Center; Franck E. Nicolini, Centre Hospitalier Lyon Sud; Meir Wetzler, Roswell Park Cancer Institute; Jeffrey H. Lipton, Princess Margaret Cancer Centre; Michele Baccarani, University of Bologna; Hanna Khoury, Emory University; Sandra Kurtin, University of Arizona Cancer Center; Elizabeth Li, PharmaStat LLC; Mihaela Munteanu, Teva Branded Pharmaceut Prod R&D; Jorge Cortes, University of Texas MD Anderson Cancer Center
• Language: English
• Date: 2016-03-03
• Publisher: Taylor & Francis: STM, Behavioural Science and Public Health Titles
• Publication Version: Final Published Version
• Copyright Statement: © 2015 Teva Pharmaceutical Industries Ltd.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3109/10428194.2015.1071486
• Title of Journal or Parent Work: Leukemia & Lymphoma
• ISSN: 1042-8194
• Volume: 57
• Issue: 3
• Start Page: 654
• End Page: 665
• Grant/Funding Information: Teva Branded Pharmaceutical Products R&D provided financial support for medical writing and editorial review in preparation for submission for publication.; The original research was sponsored by ChemGenex Pharmaceuticals Limited, Menlo Park, CA, USA (now a wholly owned subsidiary of Teva Branded Pharmaceutical Products R&D, Inc. Frazer, PA, USA).
• Keywords: Hematologic toxicity; MCL-1; SAFETY; Hematology; supportive care; CELLS; RESISTANCE; Science & Technology; thrombocytopenia; omacetaxine mepesuccinate; neutropenia; IMATINIB; Life Sciences & Biomedicine; Oncology; TYROSINE KINASE INHIBITORS; APOPTOSIS; INTOLERANCE
• Research Categories: Health Sciences, General; Health Sciences, Oncology

Abstract

Omacetaxine mepesuccinate (Synribo®) is an inhibitor of protein synthesis indicated for the treatment of patients with chronic-or accelerated-phase chronic myeloid leukemia (CML) with resistance and/or intolerance to two or more tyrosine kinase inhibitors. Myelosuppression is the most common and clinically significant toxicity experienced by patients treated with omacetaxine. Here, we further examine the patterns of hematologic toxicity observed in clinical trials and describe the approach to management as well as resolution of events. Omacetaxine-related myelosuppression typically occurs more frequently during induction cycles. In general, the myelosuppression observed with omacetaxine treatment is manageable and reversible, and long-term administration is feasible. Careful monitoring, dose delays and reduction in administration days, and appropriate supportive care are critical for successful management of hematologic toxicity. Concerns regarDing myelosuppression, observed with many cancer treatments, should not prevent eligible patients from receiving omacetaxine, particularly CML patients with unsatisfactory responses to multiple lines of prior treatment.