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[Drug therapy of chronic myeloid leukemia]
Andreas Hochhaus1, Ute Berger, Andreas Reiter
1III. Medizinische Universitätsklinik, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, Mannheim. hochhaus@uni-hd.de
Standard Treatment:
According to the evidence-based guidelines for the therapy of chronic myelogenous leukemia (CML) the combination of interferon alpha (IFN) and hydroxyurea with or without low dose ara-C is the standard treatment for chronic phase CML, if no allogeneic stem cell transplantation is requested. STI571: In cases of IFN failure the new tyrosine kinase inhibitor STI571 (Glivec) shows high response rates. STI571 specifically inhibits the BCR-ABL fusion protein which is pathogenetically relevant for CML and shows abnormal tyrosine kinase activity. 91% of all CML patients in chronic phase achieve a hematologic remission within 11 months and 55% cytogenetic remission. In blast crisis, 29% achieve hematologic remission which may be durable.
Conclusion:
The available data represent response rates. Until survival data are available, the evidence-based recommendations will remain valid.