Hematologic and cytogenetic responses to imatinib mesylate in chronic myelogenous leukemia.
BACKGROUND
Chronic myelogenous leukemia (CML) is caused by the BCR-ABL tyrosine kinase, the product of the Philadelphia chromosome. Imatinib mesylate, formerly STI571, is a selective inhibitor of this kinase.


METHODS
A total of 532 patients with late--chronic-phase CML in whom previous therapy with interferon alfa had failed were treated with 400 mg of oral imatinib daily. Patients were evaluated for cytogenetic and hematologic responses. Time to progression, survival, and toxic effects were also evaluated.


RESULTS
Imatinib induced major cytogenetic responses in 60 percent of the 454 patients with confirmed chronic-phase CML and complete hematologic responses in 95 percent. After a median follow-up of 18 months, CML had not progressed to the accelerated or blast phases in an estimated 89 percent of patients, and 95 percent of the patients were alive. Grade 3 or 4 nonhematologic toxic effects were infrequent, and hematologic toxic effects were manageable. Only 2 percent of patients discontinued treatment because of drug-related adverse events, and no treatment-related deaths occurred.


CONCLUSIONS
Imatinib induced high rates of cytogenetic and hematologic responses in patients with chronic-phase CML in whom previous interferon therapy had failed.
Kantarjian
Hagop
H
M.D. Anderson Cancer Center, Houston, TX 77030, USA. hkantarj@mdanderson.org
Sawyers
Charles
C
Hochhaus
Andreas
A
Guilhot
Francois
F
Schiffer
Charles
C
Gambacorti-Passerini
Carlo
C
Niederwieser
Dietger
D
Resta
Debra
D
Capdeville
Renaud
R
Zoellner
Ulrike
U
Talpaz
Moshe
M
Druker
Brian
B
Goldman
John
J
O'Brien
Stephen G
SG
Russell
Nigel
N
Fischer
Thomas
T
Ottmann
Oliver
O
Cony-Makhoul
Pascale
P
Facon
Thierry
T
Stone
Richard
R
Miller
Carole
C
Tallman
Martin
M
Brown
Randy
R
Schuster
Michael
M
Loughran
Thomas
T
Gratwohl
Alois
A
Mandelli
Franco
F
Saglio
Giuseppe
G
Lazzarino
Mario
M
Russo
Domenico
D
Baccarani
Michele
M
Morra
Enrica
E
D000284:Administration, Oral; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001549:Benzamides; D001772:Blood Cell Count; D003582:Cytogenetics; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D010879:Piperazines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011379:Prognosis; D011743:Pyrimidines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012044:Regression Analysis
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate