Imatinib alone and in combination for chronic myeloid leukemia.

Imatinib mesylate (STI571, Gleevec, Glivec; Novartis, Basel, Switzerland) has profoundly changed the management of chronic myeloid leukemia (CML). The unprecedented efficacy of a drug that specifically acts on the causative lesion in a malignant disorder is a proof of principle for the concept of molecular targeted therapy. This article will review the development of imatinib as a new therapy for CML. Data regarding the use of higher than the standard dose of 400 mg of imatinib and combinations of imatinib with other antileukemic agents will be discussed in the context of emerging data regarding resistance mechanisms.