Homoharringtonine, omacetaxine mepesuccinate, and chronic myeloid leukemia circa 2009

Alfonso Quintás-Cardama, Hagop Kantarjian, Jorge Cortes

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


Homoharringtonine (HHT) is a natural alkaloid that is obtained from various Cephalotaxus species. The mechanism of action by which HHT exerts its antitumor activity is through inhibition of protein synthesis and promotion of apoptosis. In the 1990s, HHT proved to be significantly active as salvage therapy for patients with chronic myeloid leukemia (CML) after failure on interferon-α therapy. However, the remarkable success of imatinib mesylate in the treatment of CML relegated HHT to oblivion. The development of omacetaxine mepesuccinate, a subcutaneously bioavailable semisynthetic form of HHT, and its activity in imatinib-resistant CML has established this agent for the second time as a valuable option in the management of this disease. Preliminary results appear to support the use of this agent for patients who have imatinib-resistant CML, including those who carry the tyrosine kinase inhibitor-insensitive mutation that exchanges the amino acids threonine and isoleucine at position 315 (the T315I mutation). In this article, the authors discuss the current data on omacetaxine and the prospects of this agent to be integrated into the state-of-the-art treatment algorithms for CML.

Original languageEnglish (US)
Pages (from-to)5382-5393
Number of pages12
Issue number23
StatePublished - Jan 12 2009
Externally publishedYes


  • BCR-ABL1 mutations
  • Chronic myeloid leukemia
  • Homoharringtonine
  • Omacetaxine mepesuccinate
  • T315I

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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