Bcr-Abl is found in more than 95% of cases with CML. The mechanism of Bcr-Abl-induced transformation is not fully understood. Bcr-Abl is a constitutively active tyrosine kinase with transforming capacity for hematopoietic cells. We demonstrated recently that the Src kinase Hck interacts directly with Bcr-Abl by a kinase-independent mechanism. Moreover, the inhibition of the Hck kinase seems to block some of the transforming effects of Bcr-Abl.
BackgroundIn the last decade, there has been a revolution in chronic myeloid leukemia
treatment with the introduction of tyrosine kinase inhibitors with imatinib
mesylate becoming the frontline therapy. ObjectiveTo evaluate the therapeutic efficacy of imatinib mesylate in treating chronic
myeloid leukemia patients and to identify factors related to therapeutic efficacy.
MethodsThis retrospective study was based on information obtained from patients' records
in the Hematology Service of Hospital Universitário Walter Cantídio
of the Universidade Federal do Ceará (HUWC / UFC). All patients diagnosed
with chronic myeloid leukemia that took imatinib mesylate for a minimum of 12
months in the period from January 2001 to January 2011 were included. From a
population of 160 patients, 100 were eligible for analysis. ResultsThe study population consisted of 100 patients who were mostly male (51%) with
ages ranging between 21 and 40 years (42%), from the countryside (59%), in the
chronic phase (95%), with high-risk prognostic factors (40%); the prognosis of
high risk was not associated with complete hematologic response or complete
cytogenetic response, but correlated to complete molecular response or major
molecular response. Reticulin condensation was associated with complete
hematologic response and complete cytogenetic response. It was found that 53% of
patients had greater than 90% adherence to treatment. The high adherence was
correlated to attaining complete cytogenetic response in less than 12 months.
Moreover,20% of patients had good response. ConclusionSignificant changes are indispensable in the monitoring of patients with chronic
myeloid leukemia. Thus, the multidisciplinary team is important as it provides
access to the full treatment and not just to medications.
ObjectiveThe aim of this study was to identify the reasons for failure in adherence to imatinib
mesylate treatment in chronic myeloid leukemia. MethodsA retrospective review was performed of 100 non-electronic records of patients with
Ph+ chronic myeloid leukemia treated with imatinib mesylate. The study
period was from January 2001 to January2011. Data were analyzed by Chi-Square and
Correspondence analysis using the Statistical Analysis System software package. ResultsAt the beginning of treatment 41% of patients were in advanced stages of the disease.
The unavailability of the drug (44.8%) and myelotoxicity (25.7%) were the most frequent
reasons for interruption. The adherence rate was < 90% in 47% of the cases. The
low adherence influenced the cytogenetic response (p-value = 0.020) and molecular
response (p-value = 0.001). Very high adherence (> 95%) induced complete cytogenetic
response, major cytogenetic response and major molecular response. ConclusionThe population of this study obtained lower-than-expected therapeutic responses
compared to other studies.
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