Perspectives on the treatment of chronic phase and advanced phase CML and Philadelphia chromosome positive ALL(1)

Leukemia. 2003 Apr;17(4):691-9. doi: 10.1038/sj.leu.2402879.

Abstract

Chronic myeloid leukaemia (CML) is a malignant disease of the bone marrow characterised by the presence of the Philadelphia (Ph) chromosome. About 20% of acute lymphoblastic leukaemia (ALL) patients also show this genetic abnormality. A new drug, imatinib (Glivec, Novartis Pharma AG, Basel, Switzerland, and formerly STI571) is having a profound effect on the treatment and management of all stages of CML and Philadelphia chromosome positive (Ph+) ALL. New treatment algorithms are being developed. Should imatinib replace or be combined with existing therapies? To address this question, we review the pros and cons of therapy with interferon-alpha (IFN-alpha), allogeneic transplantation, autologous transplantation, imatinib, and in the case of Ph+ ALL, chemotherapy and experimental approaches. Conservative and aggressive treatments will be discussed and new molecular methods of monitoring cytogenetic response and their significance will also be reviewed.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Biomarkers
  • Biomarkers, Tumor / analysis
  • Blast Crisis / therapy
  • Bone Marrow Examination
  • Bone Marrow Transplantation
  • Fusion Proteins, bcr-abl / analysis
  • Fusion Proteins, bcr-abl / antagonists & inhibitors
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Imatinib Mesylate
  • In Situ Hybridization, Fluorescence
  • Interferon-alpha / therapeutic use
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myeloid, Accelerated Phase / drug therapy*
  • Leukemia, Myeloid, Accelerated Phase / therapy
  • Life Tables
  • Neoplasm Proteins / analysis
  • Neoplasm Proteins / antagonists & inhibitors
  • Piperazines / therapeutic use
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Pyrimidines / therapeutic use
  • Remission Induction
  • Reverse Transcriptase Polymerase Chain Reaction
  • Salvage Therapy
  • Survival Analysis

Substances

  • Antineoplastic Agents
  • Benzamides
  • Biomarkers
  • Biomarkers, Tumor
  • Interferon-alpha
  • Neoplasm Proteins
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate
  • Fusion Proteins, bcr-abl