Imatinib mesylate for chronic myeloid leukemia: what do we really know?

Imatinib mesylate (GleevecTM) is a tyrosine kinase inhibitor, one of a new class of anticancer drugs called signal transduction inhibitors. A systematic review of case-series reports shows imatinib, when indirectly compared to conventional therapy, improves overall 12-month survival, but not surrogate outcomes, in individuals with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in myeloid-blast crisis, and accelerated phase. Surrogate outcomes, but not overall survival, were improved in chronic phase disease. Preliminary data from one randomized controlled trial suggest imatinib has a greater impact on surrogate outcomes compared to the combination of interferonalpha and cytarabine in patients undergoing treatment for chronic phase Ph+CML, however, it is not yet known whether it prolongs or improves quality of life.