University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA.
Oncologist. 2010;15(2):182-6. doi: 10.1634/theoncologist.2009-0297. Epub 2010 Feb 2.
Imatinib mesylate has transformed the treatment for chronic myeloid leukemia (CML). The vast majority of patients obtain hematologic remission, with a low probability of progression of disease. Yet imatinib rarely cures CML, and current recommendations dictate lifelong treatment with imatinib. In this review we analyze the biology behind the failure of imatinib to fully eradicate CML. We review evidence that indicates that the leukemic stem cell for CML is inherently resistant to imatinib, and that imatinib treatment itself may enhance this resistance.
甲磺酸伊马替尼改变了慢性髓性白血病(CML)的治疗方法。绝大多数患者获得血液学缓解,疾病进展的概率较低。然而,伊马替尼很少能治愈 CML,目前的建议是终身用伊马替尼治疗。在这篇综述中,我们分析了伊马替尼未能完全消除 CML 的生物学基础。我们回顾了表明 CML 的白血病干细胞天生对伊马替尼具有耐药性的证据,并且伊马替尼治疗本身可能增强这种耐药性。