Division of Hematology, McGill University Health Centre-Royal Victoria Hospital and McGill University, Montreal, Quebec.
Curr Oncol. 2006 Dec;13(6):201-21. doi: 10.3747/co.v13i6.124.
Chronic myelogenous leukemia (cml) is a disease characterized by the expression of Bcr/Abl, an oncogenic protein tyrosine kinase, and by evolution over time from a relatively benign chronic phase to a rapidly fatal cml blast crisis. Until recently, the standard of care included potentially curative therapy with allogeneic stem cell transplantation, available only to a minority (about 10%) of patients, or medical therapy with interferon-α with or without cytarabine, which helped to prolong the chronic phase of the disease in a minority of patients. The availability of imatinib mesylate, a selective inhibitor of Bcr/Abl approved by Health Canada in 2001, has profoundly altered the clinical and laboratory management of cml. This change in practice has been reviewed by the Canadian Consensus Group on the Management of Chronic Myelogenous Leukemia and has resulted in a new set of recommendations for the optimal care of cml patients.
慢性髓细胞白血病(cml)的特征是表达致癌蛋白酪氨酸激酶 Bcr/Abl,并随着时间的推移从相对良性的慢性期演变为快速致命的 cml 急变期。直到最近,标准的治疗方法包括异体干细胞移植,这是一种潜在的治愈性治疗方法,但只有少数(约 10%)患者可以接受,或者使用干扰素-α联合或不联合阿糖胞苷进行医学治疗,这有助于延长少数患者的慢性期。甲磺酸伊马替尼的出现改变了 cml 的临床和实验室管理,这种选择性抑制 Bcr/Abl 的药物于 2001 年获得加拿大卫生部批准。加拿大慢性髓细胞白血病管理共识小组对这一实践变化进行了审查,并制定了一套新的 cml 患者最佳治疗建议。