Tyrosine Kinase Inhibitor for Leukemia, Myeloid, Chronic-Phase

Although a single cause or environmental factor might be implicated in the development of many forms of leukemia, it appears that a large portion of cases are multifactorial and represent a spectrum of disease states.

It is important to keep in mind that leukemia can present with a variety of clinical signs, so a thorough physical exam, comprehensive laboratory studies, and complete medical history are warranted and often required to support an initial diagnosis and subsequent management. There are no specific clinical signs other than the presence or absence of a marrow aplasia (as is seen in this case).

The most common cancer in Africa is acute lymphocytic leukemia (ALL), and the second most common malignancy. The current study found that the prevalence of ALL among children and adolescents is 9%, and that it affects mainly males (male: male ratio, 3:1). We found that ALL has a prevalence of 9% for all leukemias in Cameroon, compared to the incidence of 4.4% for ALL and 3.3% for AML. We also found that the incidence of ALL was relatively higher than the WHO/FAO guidelines of 4.5%, and this was due to under-reporting.

What are common treatments for leukemia, myeloid, chronic-phase? Patients with leukemia who are treated with cytotoxic chemotherapy do well, but with an increased risk of opportunistic infections. Patients who are treated with monoclonal antibody agents are in the long-term remission and have a low risk of infection. Patients who are treated with non-chemotherapy agents are at higher risk of infection. A small number of patients have a prolonged remission with immunomodulatory agents or T cell depletion. Patients younger and older patients tend to have a poor prognosis.

It is possible to cure chronic leukemia. Most instances are with complete remission after intensive therapy with anthracyclines combined with corticosteroids. In many cases, even after complete remissions, the disease recurs and the patient dies within a few years.

The incidence of leukemic diseases is relatively low in the United States (< 1 case per 10,000 person-years for all B-Cell cancers,< 1 case per 10,000 person-years for CML,< 5 cases per 10,000 person-years for ALL,< 1 case per 10,000 person-years for AML) relative to a number of other global reference sites and are similar to incidence in the Netherlands and Northern Europe, USA.

While leukemia in patients with AML has a tendency towards high proliferation of the disease, a significant proportion of these blasts are located close to normal tissue. It is therefore quite difficult to determine the time of spread of AML to the rest of the body. In addition, it is almost impossible to predict whether or not patients with AML will develop myeloid or chronic phase disease.

Data from a recent study of this study support the hypothesis that TKIs can produce a measurable benefit to patients with CML during the CML-induction phase of treatment as evidenced by reductions in disease progression during treatment with imatinib, and a reduction in relapse rate compared to a placebo.

The data in this study showed that patients with ALL who are treated as a subgroup of the acute phase of LMP exhibited better treatment results than patients whose disease progression was treated as ALL, not as LMP. In MOP, the disease progression also was associated with a better treatment response when patients were treated as a subgroup of the chronic phase of LMP. Prospective clinical trials should continue to evaluate the treatment for ALL, MOP, and chronic phase subgroups of LMP, as well as the treatment algorithms for ALL and MOP.

This article reviews recent advances in the treatment of acute myeloid leukemia (AML), myelodysplastic/myeloproliferative disorders (MDS/PPD), and chronic myeloid leukemia (CML). All treatments have shown significant improvement in patient outcome, though there is still no cure for these diseases. Clinical trials may provide a valid benchmark for estimating their efficacy. However, clinical trials can easily be confounded by bias such as the placebo effect, reporting bias, and heterogeneity. Clinical trials, therefore, must be regarded as important, but their interpretation and comparison needs to remember that any treatment has a possible effect of its own.

The number of new cases of leukemia and myeloid, chronic-phase was highest overall in males and was low in females throughout Finland. In females, those who developed leukemia before the age of 20 (myeloid, chronic phase) and those who had been pregnant were at significantly larger risk.