Management of molecular-targeted therapy for chronic myelogenous leukemia.
OBJECTIVE
To provide primary care providers with guidelines on the evaluation and management of treatment for patients with chronic myelogenous leukemia (CML) with emphasis on the molecular-targeted therapy imatinib mesylate.


METHODS
Research-based articles in the medical literature, review articles, and clinical practice guidelines.


CONCLUSIONS
CML is a clonal stem cell disorder causing 5,000 new cases annually. Research on molecular-targeted therapy confirms that specific protein kinases have broad consequences for the development of future drugs to treat CML. The most recent discovery is a new compound, imatinib mesylate, which has become commercially available. Currently, the standard of care for CML is this agent. This therapy has changed management strategies for treatment of patients with the diagnosis of CML.


CONCLUSIONS
Long-term observations and evaluations are needed for final determination of treatment effectiveness; thus, primary care providers will follow patients with CML in the community. Unforeseen toxicity may surface, requiring accurate assessment and evaluation. Primary care providers will be actively involved with providing symptom management for these patients.
Ault
Patricia
P
Department of Leukemia, University of Texas, M. D. Anderson Cancer Center, Houston, Texas, USA. Pault@mdanderson.org
Kaled
Suzan
S
Rios
Mary Beth
MB
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001549:Benzamides; D018849:Controlled Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000451:nursing* / Q000517:prevention & control; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects; D016019:Survival Analysis
D000970:Antineoplastic Agents; D001549:Benzamides; D004791:Enzyme Inhibitors; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate