Department of Haematology, Imperial College London, Du Cane Road, London W12 0NN, UK.
Best Pract Res Clin Haematol. 2009 Sep;22(3):303-13. doi: 10.1016/j.beha.2009.08.001.
Little important progress was made in terms of prolongation of life for patients with chronic myeloid leukaemia (CML) until the advent of interferon-alpha and allogeneic stem cell transplantation in the 1980s. However, in 1998 the introduction of imatinib, the first tyrosine kinase inhibitor (TKI) that specifically targets the BCR-ABL1 oncoprotein, has fundamentally altered treatment strategies for patients in all phases of CML. Imatinib is now recommended as initial treatment for all patients who present in chronic phase (CP) and about two-thirds of patients so treated will be in continuing complete cytogenetic response 7 or more years after starting therapy. A small proportion of these patients can stop the drug without molecular evidence of relapse. For the minority of patients who are judged to have failed initial treatment with imatinib at standard dosage or increased dosage, the use of second-generation TKI or allogeneic stem cell transplantation must be considered.
直到 20 世纪 80 年代干扰素-α和同种异体干细胞移植的出现，慢性髓性白血病（CML）患者的生命延长方面才取得了一些重要的进展。然而，1998 年伊马替尼的问世，作为第一个针对 BCR-ABL1 癌蛋白的酪氨酸激酶抑制剂（TKI），从根本上改变了 CML 所有阶段患者的治疗策略。伊马替尼现被推荐用于所有处于慢性期（CP）的患者的初始治疗，约三分之二接受该治疗的患者在开始治疗 7 年或更长时间后将持续完全细胞遗传学缓解。这些患者中的一小部分在没有分子复发证据的情况下可以停止用药。对于少数被判断为对标准剂量或增加剂量的伊马替尼初始治疗失败的患者，必须考虑使用第二代 TKI 或同种异体干细胞移植。
