The treatment of CML at an environment with limited resources

Abstract

With the start of the new millennium, the International Randomized Study of Interferon-α plus cytarabine versus STI571 (IRIS) trial demonstrated a dramatic improvement in survival by comparing imatinib versus interferon alpha plus cytarabine. The Food and Drug Administration (FDA) approved imatinib as first-line treatment for newly diagnosed CML in 2001 due to its outstanding effectiveness. Years later, three second-generation (dasatinib, nilotinib, bosutinib) and one third-generation (ponatinib) tyrosine-kinase inhibitors (TKIs) were developed and approved. These highly effective treatment options, however, are not affordable for many low-income patients. Additionally, the use of drugs that effectively treat but do not cure the disease has resulted in an important economic impact for patients and health care systems worldwide, especially those in developing countries. Imatinib is the least expensive and a very effective TKI in many low-income countries. Early allogeneic stem cell transplantation must be considered in the management of selected patients before CML transformation.

Trends in disease burden of chronic myeloid leukemia at the global, regional, and national levels: a population-based epidemiologic study

“…However, CML patients in these countries still had difficulties accessing TKI-based therapy or may receive delayed therapy, thanks to the limited availability of novel drugs [ 20 ]. Additionally, the high cost of medication and monitoring was another challenge for patients in low-income countries [ 21 , 22 ]. Generic drug application and international patient assistance programs can reduce the economic burden of CML patients in countries with limited resources.…”

Jellyfish extract induces apoptotic cell death through the p38 pathway and cell cycle arrest in chronic myelogenous leukemia K562 cells

“…For the successful cases, several CML-therapeutic drugs including imatinib (known as Glivec) (Henkes, Van der Kuip & Aulitzky, 2008), dasatinib (Hochhaus & Kantarjian, 2013) and nilotinib (Saglio et al, 2010) have been clinically treated. However, such effective drugs are recently suffered from the occurrence of the unknown drug resistances in the patients (Gómez-Almaguer et al, 2016). Therefore, chemotherapeutic drugs against CML have been subjected to search from the natural resources (Kim, 2016).…”

Peer Review #3 of "Jellyfish extract induces apoptotic cell death through the p38 pathway and cell cycle arrest in chronic myelogenous leukemia K562 cells (v0.1)"

“…For the successful cases, several CML-therapeutic drugs including imatinib (known as Glivec) [49], dasatinib [50] and nilotinib [51] have been clinically treated. However, such effective drugs are recently suffered from the occurrence of the unknown drug resistances in the patients [52]. Therefore, chemotherapeutic drugs against CML have been subjected to search from the natural resources [53].…”