remains a challenge in the management of CML.
Soupir et al3 performed a multi-institutional retrospective analysis of cases of Ph+ AMLs and CML in blast crisis
and showed that Ph+ AMLs differed from CML in blast crisis
by different clinical pictures (no splenomegaly nor basophilia in Ph+ AML), bone marrow morphology (lower cellularity and myeloid to erythroid ratio in Ph+ AML), cytogenetic findings (characteristic other chromosomal abnormalities usually found in CML were not seen in Ph+ AML), and response to chemotherapy (return to normal karyotype was observed in cases of Ph+ AML, whereas persistence of Ph+ was seen in CML); however, the median survival was similar between the 2 groups.
Our findings also suggest that maintaining the level of this microRNA might represent a new therapeutic strategy for CML blast crisis
patients who do not benefit from targeted agents such as imatinib (Gleevec) and dasatinib (Sprycel)," Perrotti added.
The approval of Gleevec(x) is based on data from three Phase II open- label, single arm studies that showed a major cytogenetic response in patients with advanced stages of CML (21 per cent in the accelerated phase and 14 per cent in myeloid blast crisis
), as well as hematologic responses for patients in accelerated phase and myeloid blast crisis
(63 per cent and 26 per cent, respectively).
Responses occurred in 55 percent of those with myeloid blast crisis
, with four of those patients having their white blood cell counts returned to normal.
Approximately 3 years after the diagnosis of chronic phase CML, metamorphosis through periods of accelerated growth and blast crisis
acute basophilic leukemia and blast crisis
of CML with basophilic differentiation.
Blood smear revealed increased "vacuolated monocytes," later described as Blast forms indicating possible blast crisis
3,4) This case represents an example of simultaneous extramedullary and intramedullary CML blast crisis
High incidence of meningeal leukemia in lymphoid blast crisis
of chronic myeloid leukemia.
The START-B (abstract 0150) enrolled and treated 109 patients with myeloid blast crisis
resistant or intolerant to imatinib.
Imatinib was approved by the Food and Drug Administration in February 2002 for the treatment of patients with CML in blast crisis
, accelerated phase, or in chronic phase after failing to respond to interferon.
Numbers indicate the range of percentages in 4 studies among adult patients with Ph+ CML in blast crisis
, accelerated phase, and chronic phase.
5% of Gleevec patients progressed to the accelerated phase or blast crisis
, compared with 7% of interferon patients.
Glivec was first licensed for the treatment of patients with Philadelphia chromosome positive CML in chronic phase after failure of interferon-alpha therapy, or in accelerated phase or blast crisis
in November 2001.