[Current therapy of chronic myeloid leukemia]

Until recently the treatment options in chronic myeloid leukaemia comprised non-curative chemotherapy (formerly busulfan and dibrommanitol, later hydroxyurea and interferon) and the potentially curative allogeneic stem cell transplantation (for the minority of patients). Increasing knowledge about the pathomechanisms of disease has led to the development of a specific and highly effective molecular therapy. This stem cell disorder, characterized by the Philadelphia chromosome is dependent on the constitutively active tyrosine kinase activity of the BCR-ABL oncoprotein. A novel promising treatment modality is the selective inhibition of the BCR-ABL tyrosine kinase, by the Signal Transduction inhibitor (STI 571) imatinib mesylate which may cause a high response rate of clinical and cytogenetic remission and raise hope for a possible cure of disease by drug therapy alone. Combination of imatinib with established or investigational antileukaemic agents may lead to an increased response rate and remission duration. Further experience will show its "final" place in the treatment algorythm of chronic myeloid leukaemia.