Zdravniški Vestnik (Dec 2004)
OUR EXPERIENCE WITH TREATMENT OF CHRONIC MYELOID LEUKEMIA WITH IMATINIB MESYLATE
Abstract
Background. Imatinib mesylate is an Abl kinase inhibitor capable of producing a sustained complete molecular response in chronic myelogenous leukemia (CML). It is effective in all three phases of CML with the longest response in the chronic phase. Imatinib has been in use only since 1998 and many questions about its efficacy and use are still unanswered.Methods and results. From October 2001 until January 2004 thirty-one patients with CML have been treated with imatinib (300–600 mg/day) at our institution. Twelve patients were in chronic phase of CML, 13 in accelerated phase and 3 in blast crisis. Two were treated after unrelated peripheral blood stem cell transplantation (PBSCT) due to CML reactivation. All had been treated prior to instituting imatinib (hydroxiurea, interferon – alpha, cytarabine). Complete cytogenetic response (CCR) in patients in chronic phase occured in 33.3% and complete molecular response (CMR) occured in 41.7%. CCR in patients in accelerated phase occured in 30.8% and CMR occured in 46.2%. None of the patients in blast crisis had CCR or CMR. Several side effects were reported during the treatment. However, among them there was not the most common side effect reported in other studies. Limb muscle and bone pains (20%) were the most frequently reported side effects in our group of patients.Conclusions. Imatinib has be found to be most effective in chronic and accelerated phase of CML. However, there is still not enough data about its long-term use and prognosis. For the time being, PBSCT remains the only proven curative treatment of CML.
