Author/Editor		Modic, Mojca; Sever, Matjaž
Title		Naše izkušnje zdravljenja kronične mieloične levkemije z imatinib mesilatom
Translated title		Our experience with treatment of chronic myeloid leukemia with imatinib mesylate
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. Suppl 1
Publication year		2004
Volume		str. I-27-30
Language		slo
Abstract		Background. Imatinib mesylate is an Abl kinase inhibitor capable of producing a sustained complete molecular response in chronic myelogenous leukemia (CML). It is effective in all three phases of CML with the longest response in the chronic phase. Imatinib has been in use only since 1998 and many questions about its efficacy and use are still unanswered. Methods and results. From October 2001 until January 2004 thirty-one patients with CML have been treated with imatinib (300-600 mg/day) at our institution. Twelve patients were in chronic phase of CML, 23 in accelerated phase and 3 in blast crisis. Two were treated after unrelated peripheral blood stem, cell transplantation (PBSCT) due to CML reactivation. All had been treated prior to instituting imatinib (hydroxiurea, interferon - alpha, cytarabine). Complete cytogenetic respovase (CCR) in patients in chronic phase occured in 33.3% and complete molecular response (CMR) occured in 41.7%. CCR in patients in accelerated phase occured in 30.8% and CMR occured in 46.2%. None of the patients in blast crisis had CCR or CMR. Several side effects were reported during the treatment However, among them there was not the most common side effect reported in other studies. Limb muscle and bone pains (20%) were the most frequently reported side effects in our group of patients. Conclusions. Imatinib has be found to be most effective in chronic and accelerated phase of CML. However, there is still not enough data about its long-term use and prognosis. For the time being PBSCT remains the only proven curative treatment of CML.
Summary		Izhodišča. Imatinib mesilat je inhibitor tirozinske kinaze. Pričeli so ga uporabljati leta 1998. Z njim lahko dosežemo popolno molekularnogenetično remisijo pri kronični mieloični levkemiji (KML). Učinkovit je v vseh treh obdobjih KMI, čeprav so najdaljša obdobja molekularne remisije opisana predvsem v kroničnem obdobju. Obstaja odprtih še precej vprašanj glede trajanja molekularne remisije in preživetja bolnikov, ki so jih zdravili samo z imatinib mesilatom. Metode in rezultati. Od oktobra 2001 do januarja 2004 smo zdravili z imatinib mesilatom na KO za hematologijo v Ljubljani 31 bolnikov s KML. Dnevni odmerek imatinib mesilata je bil od 300-600 mg. Dvanajst bolnikov je bilo v kroničnem obdobju bolezni, 13 bolnikov v obdobju pospešenega poteka bolezni in 3 bolniki v blastni preobrazbi. Dva bolnika smo zdravili z imatinib mesilatom po nesorodni presaditvi perifernih krvotvornih matičnih celic (PKMC) zaradi ponovitve KML. Vsi bolniki so prej že prejemali zdravila (hidroksiurea, citozinarabinozid, interferon alfa). Pri bolnikih v kroničnem obdobju bolezni smo dosegli popolni citogenetični odgovor (PCO) pri 33,3% bolnikov, popolni molekularnogenetični odgovor (PMO) pa pri 41,7% bolnikov. V obdobju pospešenega poteka bolezni smo dosegli PCO pri 30,8% bolnikov, PMO pa pri 46,2%. Pri nobenem od bolnikov v blastni preobrazbi KML nismo dosegli PCO in PMO. Ugotavljali smo tudi neželene učinke zdravljenja z imatinib mesilatom, ki so bili taki, kot jih opisujejo v literaturi. Najpogosteje so bolniki imeli bolečine v mišicah in kosteh udov (20,0%). Zaključki. Zdravljenje KML z imatinib mesilatom je zelo učinkovito predvsem v kroničnem obdobju in pospešenem poteku bolezni. Ni pa še dolgoročnih raziskav o preživetju bolnikov, pri katerih so dosegli z imatinib mesilatom citogenetično in molekularnogenetično remisijo. Alogenična presaditev PKMC ostaja trenutno še vedno edini način ozdravitve KML.
Descriptors		LEUKEMIA, MYELOID, CHRONIC MESYLATES TREATMENT OUTCOME CYTOGENETICS HEMATOLOGIC TESTS