Keywords: chronic myeloid leukemia diagnosis and treatment
Chronic myeloid leukemia (CML) accounts for about 15% of the leukemia is divided into the chronic phase, accelerated phase, acute phase, three periods. The outstanding performance of peripheral blood especially leukocytosis splenomegaly Late obvious symptoms of consumption. Some patients suffering from CML when he does not know, and even some in the medical examination found increased leukocyte diagnosed.
CML occurrence of a characteristic of molecules (genes) based on the molecular weight of 210KD (P210) chromosomal translocation t (9; 22), resulting in Ph1 (Philadelphia) chromosome, thus forming the bcr-abl fusion gene, the final coding fusion protein, the protein having a tyrosine kinase activity continued. Sustained tyrosine kinase activity, the cells continued to proliferate and difficult apoptosis, resulting in a large number of close to the mature stage of myeloid accumulate, eventually occur CML.
As the molecular basis of the characteristic-Ph1 chromosome and bcr-abl fusion gene targeted therapy came into being for its fusion gene. STI571 (Gleevec) developed abroad specifically inhibit the bcr-abl fusion protein activity, inhibition of tyrosine kinase activity, leading to apoptosis of tumor cells, so that the CML achieved remission. Recent years as the treatment of choice of international and domestic strategies.
The STI571 applications, changed the concept of treatment of CML chronic phase high remission rate, making allogeneic bone marrow transplantation for chronic phase CML status dropped to the second-tier choice. However, accelerated and blast phase CML patients, its efficacy was significantly decreased, therefore, under the right circumstances, you can as soon as possible in the chronic phase that application of STI571. The adverse drug reactions are relatively small, mainly including edema, leukopenia, rash, muscle aches, leukopenia, but most of them can be controlled, and generally does not lead to serious consequences. However the STI571 The key question is expensive, which makes the most economic patient population can not afford. Although I Branch the China Charity STI571 Medical Center, in the northern region, able to bear the the STI571 high cost still one of the few.
Applications according to our experience, in the chronic phase of CML patients, the recommended application STI571 treatment, of course, need careful evaluation of the patient’s own economic affordability. For acceleration, and in patients with the acute phase of the need to consider a bone marrow transplant. After the two kinds of treatment option is the traditional treatment, including drugs such as chemotherapy and interferon.