Advances in the treatment of haematological malignancies: optimal sequence of CML treatment

Hochhaus, Andreas

doi:10.1093/annonc/mdm295

Cited by 12 publications

(10 citation statements)

References 49 publications

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“…There were several studies[ 4 7 11 13 ] conducted to analyze the hematological and non-hematological toxicity of imatinib and these toxicities found to be very minimal; the most common were nausea, myalgia, edema and diarrhea. [ 11 ] In another study conducted by Kantarjian et al .,[ 7 ] severe grades of non-hematologic toxic effects were infrequent and hematologic toxic effects were manageable.…”

Section: Discussionmentioning

confidence: 99%

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Comparative study for the efficacy, safety and quality of life in patients of chronic myeloid leukemia treated with Imatinib or Hydroxyurea

Jain¹,

Das²,

Ranjan³

et al. 2013

J Res Pharm Pract

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Objective:Chronic myeloid leukemia (CML) is a clonal hematopoietic disorder caused by acquired genetic defect in pluripotent stem cells characterized by acquisition of the philadelphia chromosome. The aim of this study was to compare the efficacy, safety and quality of life (QoL) in CML patients treated with imatinib or hydroxyurea.Methods:A prospective observational study was conducted on 40 patients with pathologically confirmed CML in an in-patient department of Mahavir Cancer Sansthan and Research Centre (tertiary care cancer hospital) in India. Patients were divided into two groups (group A: Imatinib consuming patients and group B: Hydroxyurea consuming patients). Complete blood count was done every month to assess the efficacy and safety/toxicity profile of these drugs. The results were analyzed 12 months after completion of treatment. QoL was assessed by The European Organization for Research and Treatment of Cancer QoL Questionnaire core 30. Hematological response was analyzed using kaplan-meier survival analysis. Chi-square test was applied to assess the association of two regimens with complete hematological response, hematological and non-hematological toxicity. White blood cell (WBC) was noted each month in every patient of each group and analyzed by generalized linear mode (repeated measures) analysis of variance (ANOVA). Independent t-test was used to compare changes in QoL between treatment groups.Findings:At the end of treatment, significant improvement (P = 0.001) in hematological response was observed in the group A (95%) compared to group B (30%). WBC count analyzed at each month of treatment by ANOVA achieved better results for patients treated with imatinib (P = 0.0001). The hematological toxicity was higher in imatinib group while non-hematological toxicity was higher in the hydroxyurea group; however only little toxicities such as nausea and constipation were statistically significant. QoL assessment of patients related to functional scale showed significantly better results in group A (P = 0.046).Conclusion:The study showed that imatinib has better profile compared to hydroxyurea, with siginificant statistical differences in terms of efficacy, non-hematological toxicity and QoL in CML patients. Even with such better efficacy and safety profile, pharmacoeconomic evaluation needs to be done to justify and support the use of imatinib for CML patients in India.

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Section: Discussionmentioning

confidence: 99%

“…Treatment intention became curative with the introduction of stem cell transplantation in the 1970 s. A prolongation of survival could be achieved by interferon alpha (IFN-α) in combination with hydroxyurea or low-dose cytarabine, particularly in low-risk patients and in patients who achieve a cytogenetic remission. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Comparative study for the efficacy, safety and quality of life in patients of chronic myeloid leukemia treated with Imatinib or Hydroxyurea

Jain¹,

Das²,

Ranjan³

et al. 2013

J Res Pharm Pract

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“…CML is characterized by a genetic abnormality known as Philadelphia (Ph) chromosome, resulting from a translocation between chromosomes 9 and 22, t(9;22)(q34;q11). This translocation generates a fusion protein called BCR-ABL which is a constitutively active tyrosine kinase responsible for uncontrolled cell proliferation and enhanced cell survival [175]. Treatments for this disease include splenic irradiation, stem cell transplantation, and interferon alpha (IFN α ) administration with combination chemotherapy.…”

Section: Pparγ and Pparγ Ligands As Potential Therapy For Hematolomentioning

confidence: 99%

Role of Peroxisome Proliferator‐Activated Receptor Gamma and Its Ligands in the Treatment of Hematological Malignancies

et al. 2008

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Peroxisome proliferator-activated receptor gamma (PPARγ) is a multifunctional transcription factor with important regulatory roles in inflammation, cellular growth, differentiation, and apoptosis. PPARγ is expressed in a variety of immune cells as well as in numerous leukemias and lymphomas. Here, we review recent studies that provide new insights into the mechanisms by which PPARγ ligands influence hematological malignant cell growth, differentiation, and survival. Understanding the diverse properties of PPARγ ligands is crucial for the development of new therapeutic approaches for hematological malignancies.

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“…Results of the IRIS study suggest that the annual mortality rate among patients with CML receiving imatinib is less than 5% in the first 5 to 6 years of treatment compared with 10% to 20% in the pre-imatinib era, and patients experiencing response to imatinib are likely to maintain their responses on long-term therapy. 14,187 However, the disease usually relapses if imatinib therapy is stopped, even in patients who experienced complete response. 188 In a pilot study (n = 12), Rousselot et al 189 suggested that discontinuation of imatinib is feasible in a subset of patients achieving sustained CMR.…”

Section: Discontinuation Of Tki Therapymentioning

confidence: 99%

Chronic Myelogenous Leukemia

O’Brien

Berman

Bhalla

et al. 2012

J Natl Compr Canc Netw

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Advances in the treatment of haematological malignancies: optimal sequence of CML treatment

Cited by 12 publications

References 49 publications

Comparative study for the efficacy, safety and quality of life in patients of chronic myeloid leukemia treated with Imatinib or Hydroxyurea

Comparative study for the efficacy, safety and quality of life in patients of chronic myeloid leukemia treated with Imatinib or Hydroxyurea

Role of Peroxisome Proliferator‐Activated Receptor Gamma and Its Ligands in the Treatment of Hematological Malignancies

Chronic Myelogenous Leukemia

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