Management of patients with newly diagnosed chronic myeloid leukemia: Opportunities and challenges

Elias Jabbour, Jorge Cortes, Susan O'Brien, Mary Beth Rios, Francis Giles, Hagop Kantarjian*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Chronic myelogenous leukemia (CML) is a progressive and often fatal hematopoietic neoplasm characterized by the presence of the Philadelphia chromosome. This arises from a balanced translocation between chromosomes 9 and 22, creating the bcr-abl fusion gene. It is often stated that the only proven curative option is allogeneic stem cell transplantation, which is indicated for only a limited subset of patients. The Bcr-Abl tyrosine kinase inhibitor imatinib represented a major advance over conventional CML therapy. After imatinib treatment, > 90% of patients had a complete hematologic response, and 70%-80% had a complete cytogenetic response. With 5 years of follow-up, the data are very encouraging and exhibit a major change in the natural history of the disease. The understanding of some of the mechanisms of resistance to imatinib has led to a rapid development of new agents that might overcome this resistance. The outlook today for patients with CML is much brighter than that of a few years ago.

Original languageEnglish (US)
Pages (from-to)S51-S57
JournalClinical Lymphoma and Myeloma
Volume7
Issue numberSUPPL. 2
DOIs
StatePublished - Mar 2007

Funding

Dr Jabbour is a member of the Speaker’s Bureau for Novartis Oncology and Bristol-Myers Squibb. Dr Cortes has received research support from Breakthrough Therapeutics, Novartis Oncology, Johnson & Johnson, Schering-Plough, Bristol-Myers Squibb, and ChemGenex Pharmaceuticals. He is also a member of the Speaker’s Bureau for Novartis Oncology and Celgene. Dr O’Brien has received research support from Genentech BioOncol, Berlex, and Biogen Idec. Dr Rios is a member of the Speaker’s Bureau for Bristol-Myers Squibb and has received other remuneration from Novartis. Dr Giles has received research support from Novartis Oncology, Bristol-Myers Squibb, Merck, SGX Pharmaceuticals, Amgen, and Pfizer. Dr Kantarjian has received research support from Bristol-Myers Squibb, Novartis Oncology, and MGI Pharma. This article includes discussion of investigational and/or unlabeled uses of drugs, including the use of nilotinib, p210 multipeptide vaccine, nonpeptide PR1 vaccine, and a heat-shock protein–70–based vaccine in the treatment of CML.

Keywords

  • Cytogenetic response
  • Immunotherapy
  • Myeloid blast crisis
  • Myelosuppression
  • Stem cell transplantation
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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