Evidence-Based Treatment of a Patient with Chronic-Phase Chronic Myeloid Leukemia by Imatinib_Chinese Journal of Evidence-Based Medicine

Authors：

DAI Yang , WU Hongmei , LI Jun

Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Chronic myeloid leukemia; Chronic phase; Imatinib; Treatment

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Objective 　We intended to get good understanding of the current role of imatinib （or glivec） in the treatment of a patient with chronic-phase chronic myeloid leukemia. Methods 　We attempted to find the current best evidence of imatinib for treating chronic myeloid leukemia in chronic phase by searching ACP Journal Club （1991 -Jun, 2005 ）, The Cochrane Library（Issue 2, 2005 ）and MEDLINE（1990 -Jun, 2005 ） and further critically appraised the available evidence.
Results 　Imatinib appeared to be more effective than current standard drag treatments in terms of hematologic and cytogenetic response with better quality of life and fewer side effects. However, there was uncertainty concerning long term outcomes. Given the current evidence together with our clinical experience and considering the patient and his family members＇ values and preference, imatinib （400 mg qd） was administered to him. No obvious adverse effects occurred with 3 months follow-up.
Conclusions 　Imatinib is effective and well tolerated in the treatment of chronic myeloid leukemia in chronic phase. Further researches on long-term follow-up data from imatinib trials are definitely needed.

Citation： DAI Yang ,WU Hongmei,LI Jun. Evidence-Based Treatment of a Patient with Chronic-Phase Chronic Myeloid Leukemia by Imatinib. Chinese Journal of Evidence-Based Medicine, 2005, 05(11): 879-881. doi: Copy

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1. Garside R, Round A, Dalziel K, Stein K, Royle P. The effectiveness and cost-effectiveness of imatinib in chronic myeloid leukaemia: a systematic review[J]. Health Technology Assessment, 2002; 6(33): 162.
2. Dalziel K, Round A, Stein K, Garside R, Price A. Effectiveness and cost-effectiveness of imatinib for first-line treatment of chronic myeloid leukaemia in chronic phase: a systematic review and economic analysis[J]. Health Technology Assessment, 2004; 8(28): 134.
3. Guyatt GH, Rennie D, Editors, The Evidence-Based Medicine Working Group. Users Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice[M]. Chicago: AMA Press; 2002.
4. National Institute for Clinical Excellence. Guidance on the use of imatinib for chronic myeloid leukaemia[M]. London: National Institute for Clinical Excellence (NICE); 2003.p26.
5. Kfantarjian HM, OBrien S, Cortes J, Giles FJ, Rios MB, Shan J, Faderl S, Garcia-Manero G, Ferrajoli A, Verstovsek S, Wierda W, Keating M, Talpaz M. Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in the chronic phase: comparison with historic data[J]. Cancer, 2003; 98(12): 2636-2642.
6. Marin D, Marktel S, Szydlo R, Klein JP, Bua M, Foot N, Olavarria E, Shepherd P, Kanfer E, Goldman JM, Apperley JF. Survival of patients with chronic-phase chronic myeloid leukaemia on imatinib after failure on interferon alfa[J]. Lancet, 2003; 362(9384): 617-619.
7. O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ; IRIS Investigators. Imatinib Compared with Interferon and Low-Dose Cytarabine for Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia[J]. N Engl J Med, 2003; 348(11): 994-1004.

Chinese Journal of Evidence-Based Medicine

Evidence-Based Treatment of a Patient with Chronic-Phase Chronic Myeloid Leukemia by Imatinib

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