Imatinib Mesylate in the Treatment of Chronic Myelogenous Leukemia

Abstract

The treatment of Chronic Myelogenous Leukemia (CML) includes marrow bone transplantation, hydroxi-urea, and Interferon-alfa (IFN-α) based therapeutic schemes; allogenic marrow bone transplantation is currently considered the only curative treatment of this malignant disease. The mean age of patients with CML is 50 years, and this associated to a lack of histologically compatible donors limits to a small portion the number of patients that can undergo a transplant. Thus, under 20% of CML patients are cured with transplant. More recently, Imatinib Mesylate (STI-571) has been developed and marketed. It is derived from 2-fenil-amino-pirimidine, and is a selective inhibitor of the BCR-ABL-tirosino-kinase, inducing hematological and cytogenetic remission, after investigation in phase I and phase II trials in CML patients resistant or highly intolerants to IFN-α in blastic, transformation or chronic stages of the disease. This bibliography review addresses CML and experimental protocols of the so-called target-treatment, as well as doses, toxicity, patient selection and possible resistance mechanisms to Imantinib Mesylate. These aspects must be fully understood, so that the impact of this drug as an antileukemia agent is properly defined in terms of survival time, either in monotherapy or associated to other drugs to treat CML, compared to the other established treatments.