NEW HOPE FOR CHRONIC MYELOGENOUS LEUKEMIA (CML)

The FDA has approved imatinib mesylate (Glivec) which is a protein tyrosine kinase inhibitor for the treatment of newly diagnosed chronic myeloid Leukemia (CML) where bone marrow transplantation is not considered first-line treatment and in chronic phase after failure of interferon alfa or in accelerated phase, or in blast crisis. Imatinib specifically blocks the action of Bcr-Abl, a protein product of the philadelphia chromosome, the well-known marker for CML and cause of the uncontrolled proliferation of white blood cells in CML.

"This drug targets only abnormal cells, and corrects the problem-an abnormal enzyne-that causes cancerous cells blocks to grou out of the control", said Ralph Vogler, M.D., scientific program director for extramural grants of the American Cancer Society. "This is another example of the emerging importance of this new class of drugs-the molecular targer drugs."

The most frequently reported drug-related adverse events noted with imatinib were nausea, vomiting, edema, and muscle cramps. Edema was most often periorbital or in lower limbs and was managed with diuretics, other supportive measures, or by reducing the dosage.

The recommended dosage of imatinib is 400 mg orally per day for patients in chronic phase of CML and 600mg orally per day for patients in accelerated phase or blast crisis.

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