Milestones and monitoring in patients with CML treated with imatinib.
Milestones and monitoring in patients with CML treated with imatinib.
复制标题
DOI：
10.1182/asheducation-2008.1.419
复制
发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Deininger, Michael W
中科院分区：
文献类型：
--
作者：
Deininger, Michael W
伊马替尼是新诊断慢性粒细胞白血病（CML）患者的治疗标准。IRIS试验的最新更新，一项在新诊断的慢性期患者中进行的标准剂量伊马替尼每日400 mg伊马替尼治疗的研究，表明无进展生存曲线稳定在高水平，这意味着大多数患者在标准治疗中表现良好。然而，大约20%至30%的患者将在伊马替尼治疗失败，需要替代疗法。识别那些可能失败的患者将是期望的，以允许预先进行更强化的治疗。在简要概述了CML的历史后，本文将回顾目前对CML患者诊断时分期的建议。接下来，将在目前接受的伊马替尼失败和次优反应标准的背景下讨论用于监测其对伊马替尼反应的各种测试。最后，将讨论在诊断时识别高风险患者的方法。
Imatinib is the therapeutic standard for newly diagnosed patients with chronic myeloid leukemia (CML). Recent updates of the IRIS trial, a study of standard-dose imatinib in newly diagnosed chronic-phase patients treated with 400 mg imatinib daily, suggest a stabilization of progression-free survival curves at a high level, implying that the majority of patients will do well on standard therapy. However, some 20% to 30% of patients will fail on imatinib and require alternative therapies. Identification of those patients likely to fail would be desirable to allow for more intensive therapy up front. After a brief overview of the history of CML, this paper will review current recommendations for staging of CML patients at diagnosis. Next, the various tests used to monitor their response to imatinib will be discussed in the context of the currently accepted criteria for imatinib failure and suboptimal response. Last, approaches to identify high-risk patients at diagnosis will be addressed.