Chronic myeloid leukemia: Current first-line treatment options

Elias Jabbour, Hagop M. Kantarjian, Jorge Cortes

Research output: Chapter in Book/Report/Conference proceedingChapter


Historically, CML was treated with busulfan or hydroxyurea, and was associated with a poor prognosis. 2,3 These agents controlled the hematological manifestations of the disease, but did not delay disease progression. Treatment with interferon alfa (IFNα) produced complete cytogenetic responses in 5 - 25 % of patients with CML in chronic phase (CP), and improved survival compared with previous treatments. 4 Combining IFNαwith cytarabine produced additional benefits. 5,6 Allogeneic stem cell transplantation (alloSCT) may be curative in CML, but it is applicable to only a fraction of CML patients and carries a significant risk of morbidity and mortality. In one recent study, the 5-year survival with IFNα(in most instances followed by imatinib) was significantly superior to that with alloSCT. 7 Imatinib mesylate, a potent and selective BCR-ABL tyrosine kinase inhibitor, is now established first-line standard therapy in CML. A complete cytogenetic response can be achieved in 50 - 60 % of patients treated in chronic phase after failure with IFNα8,9 and in over 80 % of those receiving imatinib as firstline therapy. 10,11 Responses are durable in most patients treated in early chronic phase, particularly among those who achieve major molecular responses (e.g. ≥ 3-log reduction in transcript levels). 12,13 Here we review the most current information regarding first-line therapy in CML, and briefly summarize the status of previous drugs such as IFNαand cytotoxic agents.

Original languageEnglish (US)
Title of host publicationChronic Myeloproliferative Disorders
PublisherCRC Press
Number of pages12
ISBN (Electronic)9780203091616
ISBN (Print)9780415415989
StatePublished - Jan 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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