Milestones and monitoring in patients with CML treated with imatinib.
@article{Deininger2008MilestonesAM,
title={Milestones and monitoring in patients with CML treated with imatinib.},
author={Michael W N Deininger},
journal={Hematology. American Society of Hematology. Education Program},
year={2008},
pages={
419-26
}
}Imatinib is the therapeutic standard for newly diagnosed patients with chronic myeloid leukemia (CML). Recent updates of the IRIS trial, a study of standard-dose imatinib in newly diagnosed chronic-phase patients treated with 400 mg imatinib daily, suggest a stabilization of progression-free survival curves at a high level, implying that the majority of patients will do well on standard therapy. However, some 20% to 30% of patients will fail on imatinib and require alternative therapies…
Tables and Topics from this paper
72 Citations
Initial treatment for patients with CML.
- MedicineHematology. American Society of Hematology. Education Program
- 2009
The recommendations for defining "failure" and "sub-optimal response" proposed by the European LeukemiaNet in 2006 have proved to be a major contribution to assessing responses in individual patients and are now being updated.
Managing imatinib resistance in chronic myeloid leukaemia
- Medicine, BiologyCurrent opinion in hematology
- 2010
The development of imatinib resistance, as defined by the revised European LeukemiaNet criteria, should trigger a careful review of drug adherence or recent interruptions, a repeat bone marrow aspirate and mutation analysis, and the choice between dasatinib and nilotinib should be guided by the potential adverse effects specific to each drug and relevant comorbidities.
Suboptimal Responses in Chronic Myeloid Leukemia
- Medicine, BiologyCancer
- 2012
Identification of suboptimal responders or patients failing treatment using hematologic, cytogenetic, and molecular techniques allows physicians to alter therapy earlier in the treatment course to improve long‐term outcomes.
Delayed initiation of front-line imatinib therapy predicts for poor response to nilotinib as second-line treatment of imatinib-resistant or intolerant CML: single center report of the ENACT trial in Lebanon
- Medicine, BiologyInternational Journal of Hematology
- 2012
The study objectives were to evaluate the safety profile of nilotinib, and to provide eligible patients with expanded access tonilotinib until such time as the product is commercially available.
Cost-effectiveness of dasatinib versus high-dose imatinib in patients with Chronic Myeloid Leukemia (CML), resistant to standard dose imatinib – a Swedish model application
- MedicineActa oncologica
- 2010
The results indicate that dasatinib is a cost-effective treatment among imatinib-resistant CML patients in Sweden in comparison to imatinIB 800 mg/daily.
Managing relapse of CML using therapeutic imatinib plasma level.
- MedicineClinical advances in hematology & oncology : H&O
- 2009
A 52-year-old woman had been diagnosed 7 years earlier with de novo chronic-phase chronic myelogenous leukemia (CML) with an intermediate-risk Sokal score. A complete hematologic response and…
Laboratory tools for diagnosis and monitoring response in patients with chronic myeloid leukemia.
- Medicine, BiologyThe Israel Medical Association journal : IMAJ
- 2012
The laboratory tools used for diagnosing CML, for monitoring during treatment, and for assessing remission or relapse are discussed and the efforts to standardize molecular monitoring for CML patient management are discussed.
Interpretation of cytogenetic and molecular results in patients treated for CML.
- Biology, MedicineBlood reviews
- 2011
Molecular Monitoring and Treatment of Chronic Myeloid Leukemia (CML)
- Medicine, Biology
- 2012
This review discusses the aspects of molecular monitoring of CML in the context of recent advances in its treatment strategies and provides guidelines to both clinicians and laboratory physicians in choosing the appropriate methodology for laboratory monitoring and in interpretation of the results for effective therapeutic decision-making.
Hematologic, cytogenetic, and molecular responses to imatinib therapy for chronic myeloid leukemia: a single-center experience in Turkey
- Medicine
- 2012
Patients with chronic-phase CML patients' responses to imatinib therapy were similar to those seen in other countries, although their group had a lower rate of adverse events.
References
SHOWING 1-10 OF 43 REFERENCES
Dasatinib induces significant hematologic and cytogenetic responses in patients with imatinib-resistant or -intolerant chronic myeloid leukemia in accelerated phase.
- Medicine, BiologyBlood
- 2007
Dasatinib induced significant hematologic and cytogenetic responses in patients with imatinib resistance or intolerance, was well tolerated, and may represent a potent new therapeutic option for CML-AP.
Imatinib for newly diagnosed patients with chronic myeloid leukemia: incidence of sustained responses in an intention-to-treat analysis.
- Medicine, BiologyJournal of clinical oncology : official journal of the American Society of Clinical Oncology
- 2008
Imatinib is highly effective in most patients with CML-CP; patients who respond are likely to live substantially longer than those treated with earlier therapies, however, approximately one third of patients still need better therapy.
Imatinib improves but may not fully reverse the poor prognosis of patients with CML with derivative chromosome 9 deletions.
- Medicine, BiologyBlood
- 2003
No difference in survival is found between patients with and without deletions of the derivative chromosome 9, contrasting with previous reports in cohorts with a lower proportion of patients treated with imatinib.
Evolving concepts in the management of chronic myeloid leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet.
- MedicineBlood
- 2006
It is recommended that the preferred initial treatment for most patients newly diagnosed in chronic phase should now be 400 mg IM daily and the value of IM (400 mg/day) and of conventional allogeneic hematopoietic stem cell transplantation (alloHSCT) is confirmed.
Significance of Suboptimal Response to Imatinib, as Defined by the European LeukemiaNet, in Long-Term Outcome for Patients (Pts) with Chronic Phase (CP) Chronic Myeloid Leukemia (CML).
- Medicine
- 2007
After 3 mo of therapy none of the 273 evaluable pts met definition of suboptimal response according to the European LeukemiaNet, while 3 of 273 (1%) met definition for failure.
Monitoring CML patients responding to treatment with tyrosine kinase inhibitors: review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results.
- BiologyBlood
- 2006
Suggestions are made for harmonizing the differing methodologies for measuring BCR-ABL transcripts in patients with CML undergoing treatment and using a conversion factor whereby individual laboratories can express BCR -ABL transcript levels on an internationally agreed scale.
Frequency of major molecular responses to imatinib or interferon alfa plus cytarabine in newly diagnosed chronic myeloid leukemia.
- Medicine, BiologyThe New England journal of medicine
- 2003
The proportion of patients with CML who had a reduction in BCR-ABL transcript levels of at least 3 log by 12 months of therapy was far greater with imatinib treatment than with treatment with interferon plus cytarabine.
A Transcriptomal Profile for Predicting Complete Cytogenetic Response (CCR) in Chronic Phase CML Patients Treated with Imatinib.
- Biology, Medicine
- 2007
The transcriptional profiles of CD34+ cell from prospective cytogenetic responders and non-responders are distinct and a classifier based on the learning set predicted cytogenetics response in a totally independent validation set with ∼86% accuracy, making this one of the first prospectively validated classifiers.
A Phase II Study of Dasatinib in Patients with Chronic Myeloid Leukemia (CML) in Myeloid Blast Crisis Who Are Resistant or Intolerant to Imatinib: First Results of the CA180006 ‘START-B’ Study.
- Medicine, Biology
- 2005
Preliminary data from this Phase II study provide further evidence of the activity of dasatinib in CML patients with MBC and of its acceptable safety profile.
Imatinib mesylate therapy may overcome the poor prognostic significance of deletions of derivative chromosome 9 in patients with chronic myelogenous leukemia.
- Medicine, BiologyBlood
- 2005
Treatment with imatinib mesylate overcomes the adverse prognostic significance of der(9) deletions in patients with CML and in a multivariate analysis, der( 9) deleting had no significant impact on response, survival, or response duration.
