Document Detail


Chronic myeloid leukemia: current status and controversies.
MedLine Citation:
PMID:  15255169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Until recently, the standard treatment for newly diagnosed patients with chronic myeloid leukemia (CML) in chronic phase who were not eligible for allogeneic stem cell transplant was interferon-alfa alone or in combination with low-dose cytarabine. Moreover, about 20% to 25% of patients who were relatively young and had suitable HLA-matched donors have in recent years been offered treatment by allogeneic stem cell transplantation, a procedure that can cure CML but is associated with an appreciable risk of morbidity and mortality. However, following the recognition in the 1980s that the p210 oncoprotein encoded by the BCR-ABL fusion gene on the Philadelphia chromosome had greatly enhanced tyrosine kinase activity and was probably the initiating event in the chronic phase of CML, much effort was directed toward development of drugs that would selectively inhibit this kinase activity. In 1998 these efforts culminated in the first clinical use of imatinib mesylate (Gleevec), which has since been shown to produce impressive results in treatment of patients with CML in chronic phase. In previously untreated patients, the incidence of complete cytogenetic responses exceeds 80%, and the majority of responses appear thus far to be durable. Imatinib also proved active in patients with accelerated phase and blastic phase disease, but in most of these cases, the benefits have been relatively short-lived. The advent of imatinib has thus necessitated a fundamental reappraisal of the approach to the initial management of CML.
Authors:
Tariq I Mughal; John M Goldman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Oncology (Williston Park, N.Y.)     Volume:  18     ISSN:  0890-9091     ISO Abbreviation:  Oncology (Williston Park, N.Y.)     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-07-16     Completed Date:  2004-09-21     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8712059     Medline TA:  Oncology (Williston Park)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  837-44, 847; discussion 847-50, 853-4     Citation Subset:  IM    
Affiliation:
Department of Haematology, Hammersmith Hospital at the Imperial College London, London, United Kingdom. tmughal@freenet.co.uk
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MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic
Fusion Proteins, bcr-abl / genetics
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*,  genetics,  pathology
Patient Selection
Philadelphia Chromosome
Piperazines / therapeutic use*
Prognosis
Protein-Tyrosine Kinases / pharmacology
Pyrimidines / therapeutic use*
Stem Cell Transplantation
Chemical
Reg. No./Substance:
0/Fusion Proteins, bcr-abl; 0/Piperazines; 0/Pyrimidines; 152459-95-5/imatinib; EC 2.7.10.1/Protein-Tyrosine Kinases

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