Druker B J, Sawyers C L, Capdeville R, Ford J M, Baccarani M, Goldman J M
Oregon Health and Science University, Portland, OR 97201-3098, USA.
Hematology Am Soc Hematol Educ Program. 2001:87-112. doi: 10.1182/asheducation-2001.1.87.
The treatment recommendations for chronic myelogenous leukemia (CML) are evolving rapidly. In the past year, pegylated interferon and STI571 (Gleevec, imatinib mesylate), a Bcr-Abl tyrosine kinase inhibitor, have become commercially available and non-myeloablative stem cell transplants continue to be refined. Clinicians and patients face a bewildering array of treatment options for CML. In this article Dr. Sawyer reviews the clinical results with STI571 and ongoing investigations into mechanisms of resistance to STI571. Given the newness of STI571, a practical overview on the administration of STI571 is presented by Drs. Druker and Ford, focusing on aspects such as optimal dose, management of common side effects, and potential drug interactions. The most recent data on interferon-based regimens are reviewed by Dr. Baccarani in the third section. In the last section Dr. Goldman presents recent results of allogeneic stem cell transplants, including the reduced intensity conditioning regimens. Lastly, the proposed place of each of these treatments in the management of CML patients is addressed to assist in deciding amongst treatment options for CML patients.
慢性粒细胞白血病（CML）的治疗建议正在迅速演变。在过去的一年里，聚乙二醇化干扰素和Bcr-Abl酪氨酸激酶抑制剂STI571（格列卫，甲磺酸伊马替尼）已上市，非清髓性干细胞移植也在不断完善。临床医生和患者面对CML的一系列治疗选择时感到困惑。在本文中，索耶医生回顾了STI571的临床结果以及对STI571耐药机制的正在进行的研究。鉴于STI571是新药，德鲁克医生和福特医生给出了关于STI571给药的实用概述，重点关注最佳剂量、常见副作用的管理以及潜在药物相互作用等方面。巴卡拉尼医生在第三部分回顾了基于干扰素方案的最新数据。在最后一部分，戈德曼医生介绍了异基因干细胞移植的最新结果，包括降低强度预处理方案。最后，探讨了这些治疗方法在CML患者管理中各自建议的地位，以帮助在CML患者的治疗选择中做出决定。
