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Treatment of CML

Treatment of CML. Goal of Therapy. Complete molecular remission and cure Achieve prolonged, durable, nonneoplastic, nonclonal hematopoiesis, Eradication of any residual cells containing the BCR/ABL transcript. Imatinib Mesylate.

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Treatment of CML

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  1. Treatment of CML

  2. Goal of Therapy • Complete molecular remission and cure • Achieve prolonged, durable, nonneoplastic, nonclonal hematopoiesis, • Eradication of any residual cells containing the BCR/ABL transcript

  3. Imatinib Mesylate • MOA: competitive inhibition at the ATP binding site of the Ablkinasein the inactive confirmation -> inhibition of tyrosine phosphorylationof proteins in Bcr/ Abl signal transduction • Complete hematologic remission rate: 97% at 18 months • Side effects: Myelosuppression, fluid retention, nausea, muscle cramps, diarrhea

  4. Proposed Imatinib Treatment Milestones for Newly Diagnosed CML Patients

  5. Allogeneic SCT Criteria for patient Acceptable end organ function Less than 70 years old Have healthy histocompatible donor Criteria for donor Fully matched or mismatched only at one HLA locus

  6. Proposed Imatinib Treatment Milestones for Newly Diagnosed CML Patients

  7. Outcome of SCT • Patient (age and phase of disease) • Type of Donor • Preparative regimen • GVHD • Posttransplantaion treatment: • BCR/ABL transcript levels are early predictors for hematologic relapse following transplantation • Imatinib

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