Treatment of chronic myeloid leukemia when imatinib fails

Abstract

Introduction: Imatinib failure represents a major clinical challenge in the management of chronic myeloid leukemia.

Areas covered: Definition of failure, its causes, the various approaches to the treatment of imatinib failure such as imatinib dose escalation, second-generation tyrosine kinase inhibitors and stem cell transplantation, and monitoring of residual disease are covered in this review. Selected investigational agents and the management of blast crisis are also reviewed. After reading the review the reader will understand how to manage imatinib failure.

Expert opinion: Imatinib failure can be managed in most cases by a careful appraisal of its causes and a rational selection of treatment options.

Keywords::

• chronic myeloid leukemia
• clonal evolution
• dasatinib
• imatinib failure
• nilotinib
• resistance mutants
• transplantation

Acknowledgement

The support by the German José Carreras Leukemia Foundation, (DJCLS H09/01f, H06/04v, H03/01) Deutsche Krebshilfe (Nr. 106642) and European Commission (LSHC-CT-2004-503216) is gratefully acknowledged.

Notes

This box summarizes key points contained in the article.