New Approaches to the Treatment of Chronic Myelogenous Leukemia
A number of therapeutic strategies have been introduced for the management and treatment of the benign phase of CML. Eighty years ago, radiation therapy was the only available treatment and splenic irradiation was continued for a period in excess of 20 years when in 1924, Minot and colleagues published the now classic paper demonstrating that, although therapy could reduce morbidity of the disease, the median duration of survival with or without therapy was the same. Because of symptomatic relief, radiation therapy or 32P were the methods of choice until the introduction of busulfan in the early 1950s. The initial study with busulfan showed median survival of 42 months and did not appear to be a significant improvement over radiation therapy, although symptomatic improvement was again seen and this is still true today. A number of other agents have been used in an attempt to delay the onset of blast crisis and prolong survival, the most commonly used being hydroxyurea, dibromomannitol, melphalan, and 6-mercaptopurine. In addition, nitrogen mustard, cyclophosphamide, and vinca alkaloids have been used in an attempt to manage the disease.
KeywordsChronic Myelogenous Leukemia Blast Crisis Vinca Alkaloid Philadelphia Chromosome Nitrogen Mustard
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