[Developments in the treatment of patients with chronic myeloid leukemia].
In the treatment of chronic myelocytic leukaemia (CML) allogeneic bone marrow transplantation (BMT) from a sibling donor is the treatment of choice in patients younger than 50 years; the overall 5-year survival is about 60%. Donor lymphocyte infusion without chemotherapy may serve as an efficacious therapy for recurrence of CML after allogeneic BMT. Application of allogeneic BMT from a matched unrelated donor is increasing, but the outcome is still inferior to that of sibling BMT, largely due to more severe and more frequent complications. Treatment with interferon-alpha has been shown to prolong the overall median survival, but especially in a subgroup of patients (about 15%) who achieve a major cytogenic response. Combination of interferon-alpha and low-dose cytarabine leads to increased survival and a better cytogenic response than interferon-alpha alone. Current investigations are aimed at further improving survival and cytogenic response by using more intensive chemotherapy, such as high-dose cytarabine, followed by interferon-alpha maintenance therapy.
Cornelissen
J J
JJ
Afd. Hematologie, Academisch Ziekenhuis Rotterdam-Daniel den Hoed Kliniek.
Löwenberg
B
B
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000379:methods; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000627:therapeutic use; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000628:therapy*; D017710:Lymphocyte Transfusion; D008875:Middle Aged
D000964:Antimetabolites, Antineoplastic; D016898:Interferon-alpha; D003561:Cytarabine