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Treatment of chronic myeloid leukemia when imatinib fails

Rüdiger Hehlmann1, Susanne Jung-Munkwitz, Susanne Saussele

  • 1III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, Mannheim, Germany. ruediger.hehlmann@medma.uni-heidelberg.de

Expert Opinion on Pharmacotherapy
|January 14, 2011
PubMed
Abstract

Insights

Imatinib failure in chronic myeloid leukemia (CML) is a significant challenge. This review outlines management strategies, including dose escalation, alternative tyrosine kinase inhibitors, and stem cell transplantation, to effectively treat CML patients experiencing imatinib failure.

Area of Science:

  • Hematology
  • Oncology
  • Pharmacology

Background:

  • Imatinib failure presents a substantial clinical hurdle in managing chronic myeloid leukemia (CML).
  • Understanding the reasons behind treatment resistance is crucial for effective patient care.

Purpose of the Study:

  • To provide a comprehensive overview of imatinib failure in CML.
  • To guide clinicians in selecting appropriate management strategies for CML patients resistant to imatinib.

Main Methods:

  • Review of existing literature on imatinib failure in chronic myeloid leukemia.
  • Analysis of treatment options including dose escalation, second-generation TKIs, and stem cell transplantation.
  • Discussion on monitoring residual disease and managing advanced phases like blast crisis.

Main Results:

  • Imatinib failure can stem from various causes, necessitating individualized treatment approaches.
  • Multiple therapeutic options exist, including escalating imatinib dosage, switching to newer tyrosine kinase inhibitors, or considering stem cell transplantation.
  • Effective management relies on accurate diagnosis of failure causes and tailored therapeutic selection.

Conclusions:

  • Most cases of imatinib failure in CML can be successfully managed.
  • A thorough evaluation of the causes of failure and a rational choice of treatment are key to successful outcomes.

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