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1. Morel F, Bris MJ, Herry A, Calvez GL, Marion V, Abgrall JF, Berthou C, Braekeleer MD: Double minutes containing amplified bcr-abl fusion gene in a case of chronic myeloid leukemia treated by imatinib. Eur J Haematol; 2003 Apr;70(4):235-9
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  • [Title] Double minutes containing amplified bcr-abl fusion gene in a case of chronic myeloid leukemia treated by imatinib.
  • Amplification of the bcr-abl fusion gene has recently been associated with resistance to imatinib therapy in chronic myeloid leukemia (CML).
  • A 55-yr-old man was diagnosed with Philadelphia (Ph) chromosome-positive CML.
  • Resistance to interferon treatment and occurrence of blastic phase lead to the decision of imatinib therapy.
  • A second blastic phase occurred 4 months after transplantation, of which the patient died.
  • To the best of our knowledge, dmin containing amplified bcr-abl gene has never been reported in patients with CML.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Blast Crisis / genetics. Drug Resistance, Neoplasm / genetics. Enzyme Inhibitors / therapeutic use. Fusion Proteins, bcr-abl / genetics. Gene Amplification. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Neoplasm Proteins / genetics. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Aneuploidy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Benzamides. Chromosome Aberrations. Chromosome Painting. Combined Modality Therapy. Cytarabine / administration & dosage. Fatal Outcome. Humans. Hydroxyurea / administration & dosage. Imatinib Mesylate. Interferon-alpha / administration & dosage. Karyotyping. Male. Middle Aged. Peripheral Blood Stem Cell Transplantation. Philadelphia Chromosome. Transplantation, Autologous


2. Fujimaki K, Maruta A, Yoshida M, Yamazaki E, Matsuzaki M, Fujisawa S, Kanamori H, Ishigatsubo Y: [Complete cytogenetic response obtained with unrelated donor lymphocyte infusion for relapse of chronic myeloid leukemia in blastic crisis after allogeneic bone marrow transplantation]. Rinsho Ketsueki; 2001 Mar;42(3):204-8
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  • [Title] [Complete cytogenetic response obtained with unrelated donor lymphocyte infusion for relapse of chronic myeloid leukemia in blastic crisis after allogeneic bone marrow transplantation].
  • A 35-year-old man with chronic myeloid leukemia (CML) in blastic crisis (BC) received an allogeneic bone marrow transplant from an unrelated donor in October 1998 after three cycles of chemotherapy.
  • BC relapse developed on day 349 after transplantation.
  • After one cycle of chemotherapy and treatment with interferon, the patient received donor lymphocyte infusion (DLI), and this resulted in a complete cytogenetic response 21 days later.
  • Grade III acute graft-versus-host disease developed on day 25 after DLI, but this was resolved after administration of prednisolone.
  • Disease relapse occurred at extramedullary sites on day 162 after DLI, and the patient died of sepsis after receiving chemotherapy.
  • This case illustrates that unrelated DLI can induce remission successfully in patients with relapse of CML in BC through a graft-versus-leukemia effect.
  • [MeSH-major] Blast Crisis. Bone Marrow Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Lymphocyte Transfusion
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Male. Remission Induction. Tissue Donors


3. Ilaria RL Jr: Pathobiology of lymphoid and myeloid blast crisis and management issues. Hematology Am Soc Hematol Educ Program; 2005;:188-94
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  • [Title] Pathobiology of lymphoid and myeloid blast crisis and management issues.
  • Despite recent improvements in the treatment of early-stage disease, the blastic phase of chronic myeloid leukemia (CML) remains a therapeutic challenge.
  • For imatinib-naïve patients, imatinib provided encouraging hematologic and cytogenetic benefits; however, the vast majority of CML blast crisis cases today arise in patients already on imatinib-based therapy.
  • Clonal evolution and duplication of the Philadelphia chromosome continue to be associated with blastic phase transformation, but recent studies have identified BCR/ABL kinase domain mutations in 30%-40% of blast crisis patients.
  • This implies that BCR-ABL-targeted therapy might have influenced the molecular road map to blastic transformation.
  • In this review, we will examine the effect of imatinib on primitive CML progenitors and how this might influence the pathophysiology of blast crisis.
  • A rational framework for deciding how best to integrate stem cell transplantation, traditional chemotherapy, imatinib, and other BCR-ABL kinase inhibitors in the care of blast crisis patients will also be discussed.

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  • (PMID = 16304379.001).
  • [ISSN] 1520-4383
  • [Journal-full-title] Hematology. American Society of Hematology. Education Program
  • [ISO-abbreviation] Hematology Am Soc Hematol Educ Program
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Protein-Tyrosine Kinases; EC 2.7.10.2 / Fusion Proteins, bcr-abl
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4. Dutcher JP, Lee S, Gallagher RE, Makary AZ, Hines JD, Londer H, Farnen JP, Bennett JM, Paietta E, Rowe JM, Goloubeva O, Wiernik PH, Eastern Cooperative Oncology Group: Phase II study of all-trans retinoic acid in the accelerated phase or early blastic phase of chronic myeloid leukemia: a study of the Eastern Cooperative Oncology Group (E1993). Leuk Lymphoma; 2005 Mar;46(3):377-85
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  • [Title] Phase II study of all-trans retinoic acid in the accelerated phase or early blastic phase of chronic myeloid leukemia: a study of the Eastern Cooperative Oncology Group (E1993).
  • The aims of this study were to evaluate the safety and efficacy of all-trans retinoic acid (ATRA) in the treatment of the accelerated and blastic phase of chronic myeloid leukemia (CML) and to evaluate in vitro correlates of biological activity.
  • ATRA was administered in an intermittent schedule to patients with CML in the accelerated or blastic phases for a 6 week induction period, which was continued if there was evidence of clinical response or stable disease.
  • Laboratory correlative studies were performed prior to treatment and at intervals during treatment to evaluate effects on maturation and differentiation, and on CML progenitor cell growth by assessment of colony-forming cells (CFC).
  • Laboratory data for the responders demonstrated high sensitivity of primary CFC to ATRA prior to treatment and low serial CFC counts on ATRA therapy.
  • ATRA demonstrated clinical and hematological activity in 5 of 18 patients with the accelerated phase of CML, and there was evidence of a biological effect in laboratory studies of 3 of the 5 patients' progenitor cells.
  • Combination therapy with other differentiating agents may be useful in this disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Tretinoin / administration & dosage
  • [MeSH-minor] Adult. Aged. Blast Crisis. Combined Modality Therapy. Cytogenetic Analysis. Disease-Free Survival. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Interferon-alpha / administration & dosage. Interferon-alpha / adverse effects. Male. Middle Aged. Recombinant Proteins. Survival Analysis. Time Factors

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  • (PMID = 15621827.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 11083; United States / NCI NIH HHS / CA / CA 14548; United States / NCI NIH HHS / CA / CA 14958; United States / NCI NIH HHS / CA / CA 23318; United States / NCI NIH HHS / CA / CA 66636; United States / NCI NIH HHS / CA / CA21115
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Interferon-alpha; 0 / Recombinant Proteins; 5688UTC01R / Tretinoin; 76543-88-9 / interferon alfa-2a
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5. Voglová J, Maisnar V, Beránek M, Chrobák L: [Combination of imatinib and anagrelide in treatment of chronic myeloid leukemia in blastic phase]. Vnitr Lek; 2006 Sep;52(9):819-22
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  • [Title] [Combination of imatinib and anagrelide in treatment of chronic myeloid leukemia in blastic phase].
  • Chronic myeloid leukemia in blast phase (BP) is resistant to chemotherapy and majority of patients die within 6 months.
  • Inhibitor Bcr-Abl tyrosine kinase imatinib mesylate dramatically improved outcome of patients in chronic phase (CP) and is also effective in BP of CML.
  • High platelet counts are often observed at diagnosis or in the subsequent course of the CML in about 25% of patients.
  • Anagrelide selectively reduces circulating platelets and is used in treatment of thrombocythemia in chronic myeloproliferative disorders.
  • Efficacy and safety of combination imatinib mesylate with anagrelide was demonstrated in chronic and accelerated phase of CML.
  • 51-year-old white man with CML presented in blast phase was followed for 4 years.
  • Imatinib mesylate in dose of 600 mg p.o. qd. was administered after the failure of initial chemotherapy.
  • The patient tolerated the combination of imatinib and anagrelide well and long-term survival gave him the chance of treatment with the new tyrosin kinase inhibitor (dasatinib).
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Blast Crisis / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / administration & dosage. Platelet Aggregation Inhibitors / administration & dosage. Protein Kinase Inhibitors / administration & dosage. Pyrimidines / administration & dosage. Quinazolines / administration & dosage. Thrombocytosis / drug therapy


6. Park SJ, Kim DW, Kim HJ, Eom HS, Min CK, Lee JW, Min WS, Kim CC: Topotecan-based combination chemotherapy in patients with transformed chronic myelogenous leukemia and advanced myelodysplastic syndrome. Korean J Intern Med; 2000 Jul;15(2):122-6
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  • [Title] Topotecan-based combination chemotherapy in patients with transformed chronic myelogenous leukemia and advanced myelodysplastic syndrome.
  • BACKGROUND: Patients with transformed chronic myelogenous leukemia(CML) and advanced myelodysplastic syndrome(MDS) have poor prognosis.
  • The aim of this study is to evaluate the feasibility of second chronic phase induction in accelerated phase(CML-AP) or blastic crisis of CML(CML-BC) and remission induction in advanced MDS by combining topoisomerase I inhibitor (topotecan) with topoisomerase II inhibitor(mitoxantrone).
  • Eighteen patients with transformed CML(7 CML-AP, 11 CML-BC) and 6 patients with advanced MDS were treated.
  • Four of 7 patients with CML-AP(57%), 2 of 4 patients with CML-lymphoid blastic crisis (-LBC)(50%) and 2 of 6 patients with advanced MDS(33%) had CR lasting more than 45 days(45 to 400 days).
  • There was no CR in the patients with CML-myeloid blastic crisis(-MBC).
  • In patients who recovered their neutrophil count, the absolute neutrophil count(ANC) remained below 500/microL for a period of 13 to 58 days(median 21 days) and the time to ANC recovery was associated with pretreatment severity of bone marrow fibrosis(mainly CML patients).
  • CONCLUSION: The combination of topotecan-mitoxantrone has shown modest activity in CML-AP, CML-LBC and advanced MDS with acceptable toxicities.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Myelodysplastic Syndromes / drug therapy. Topotecan / administration & dosage


7. Sureda A, Carrasco M, de Miguel M, Martínez JA, Conde E, Sanz MA, Díaz-Mediavilla J, Sierra J: Imatinib mesylate as treatment for blastic transformation of Philadelphia chromosome positive chronic myelogenous leukemia. Haematologica; 2003 Nov;88(11):1213-20
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  • [Title] Imatinib mesylate as treatment for blastic transformation of Philadelphia chromosome positive chronic myelogenous leukemia.
  • BACKGROUND AND OBJECTIVES: Imatinib mesylate (STI571) is a selective inhibitor of the bcr/abl tyrosine kinase with therapeutic potential in the blast crisis (BC) of chronic myelogenous leukemia (CML).
  • DESIGN AND METHODS: We report the characteristics and clinical outcome of 30 patients [16 males and 14 females, median age 50 (range, 18 to 72) years] with CML in BC included in a phase II international multicenter extended trial of treatment with imatinib.
  • RESULTS: Eighteen patients (60%) achieved a sustained hematologic remission (SHR) at a median time of 4 weeks (range, 2-14) after starting therapy.
  • Four patients (13%) achieved a cytogenetic remission at a median time of 8 weeks (range, 6-10) after beginning imatinib therapy.
  • In univariate analysis, the achievement of a SHR was more frequent in patients without a complex karyotype and in those receiving imatinib without having had previous chemotherapy.
  • A long interval between the diagnosis of BC and imatinib therapy (> or = 9.5 weeks) (p=0.0011), the presence of additional cytogenetic abnormalities (p=0.015), and extramedullary involvement (p=0.02) were associated with significantly shorter EFS.
  • Multivariate analyses indicated that the time interval between the diagnosis of BC and the beginning of imatinib therapy was the only significant prognostic factor for both EFS and OS.
  • INTERPRETATION AND CONCLUSIONS: STI571 therapy produces a high percentage of SHR in patients with CML in BC; a minority of the patients also obtain some degree of cytogenetic response.
  • Nevertheless, these responses are transient and additional therapy should be offered.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Blast Crisis / drug therapy. Enzyme Inhibitors / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Aged. Benzamides. Disease-Free Survival. Female. Fusion Proteins, bcr-abl / antagonists & inhibitors. Fusion Proteins, bcr-abl / blood. Humans. Imatinib Mesylate. Karyotyping. Male. Middle Aged. Neoplasm Proteins / antagonists & inhibitors. Neoplasm Proteins / blood. Neutropenia / chemically induced. Remission Induction. Survival Analysis. Thrombocytopenia / chemically induced. Treatment Outcome

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  • (PMID = 14607749.001).
  • [ISSN] 1592-8721
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Enzyme Inhibitors; 0 / Neoplasm Proteins; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.2 / Fusion Proteins, bcr-abl
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8. Myojo T, Hino N: Complete remission from chronic myelogenous leukemia--blastic crisis caused by reduced intensity stem cell transplantation following partial remission due to imatinib. Intern Med; 2004 Feb;43(2):126-30
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  • [Title] Complete remission from chronic myelogenous leukemia--blastic crisis caused by reduced intensity stem cell transplantation following partial remission due to imatinib.
  • We report a 55-year-old man who showed no change after chemotherapy for chronic myelogenous leukemia-blastic crisis (CML-BC) in 1998.
  • There are still no established radical methods of treating CML-BC.
  • Thus, therapy by allograft after the patient has entered hematological remission with imatinib is considered a new way of dealing with cases of CML-BC.
  • [MeSH-major] Blast Crisis / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery. Peripheral Blood Stem Cell Transplantation / methods. Piperazines / therapeutic use. Protein-Tyrosine Kinases / antagonists & inhibitors. Pyrimidines / therapeutic use

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  • (PMID = 15005255.001).
  • [ISSN] 0918-2918
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Protein-Tyrosine Kinases
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9. Yalman N, Sarper N, Devecioğlu O, Anak S, Eryilmaz E, Can M, Yenilmez H, Ağaoğlu L, Gedikoğlu G: Fludarabine, cytarabine, G-CSF and idarubicin (FLAG-IDA) for the treatment of relapsed or poor risk childhood acute leukemia. Turk J Pediatr; 2000 Jul-Sep;42(3):198-204
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  • [Title] Fludarabine, cytarabine, G-CSF and idarubicin (FLAG-IDA) for the treatment of relapsed or poor risk childhood acute leukemia.
  • The prognosis of relapsed acute leukemia or chronic leukemia in acute blast crisis is poor and new chemotherapeutic regimens could be useful for these patients.
  • Six relapsed acute lymphoblastic leukemia (ALL), nine relapsed acute myeloblastic leukemia (AML), one chronic myelomonocytic leukemia (CMML) and one chronic myeloid leukemia (CML) in acute blast crisis between three to 18 years (median 10 years) received fludarabine, cytarabine, G-CSF and idarubicin (FLAG-IDA) chemotherapy (CT).
  • The regimen was ineffective in B-cell ALL as in acute blastic crisis of CMML and CML.
  • FLAG-IDA appears to be a myelotoxic therapy for relapsed or poor risk leukemia in a developing country.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myeloid, Acute / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Salvage Therapy / methods. Vidarabine / analogs & derivatives

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  • (PMID = 11105617.001).
  • [ISSN] 0041-4301
  • [Journal-full-title] The Turkish journal of pediatrics
  • [ISO-abbreviation] Turk. J. Pediatr.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] TURKEY
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; 143011-72-7 / Granulocyte Colony-Stimulating Factor; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine; ZRP63D75JW / Idarubicin
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10. Goto H, Tsurumi H, Hara T, Moriwaki H: Lymphoid blast crisis during interferon-alpha therapy in a patient with chronic myelogenous leukemia in myeloid blast crisis. Int J Hematol; 2000 Dec;72(4):474-6
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  • [Title] Lymphoid blast crisis during interferon-alpha therapy in a patient with chronic myelogenous leukemia in myeloid blast crisis.
  • It was determined that she had chronic myelogenous leukemia (CML) in myeloid blast crisis.
  • Hydroxyurea was started initially, and the blasts completely disappeared from peripheral blood on day 9 of therapy.
  • Treatment with adriamycin, vincristine, and prednisolone (AdVP) was immediately started, which rapidly reduced the lymphoblasts.
  • The ratio between myeloblasts and lymphoblasts depended on the treatment (IFN-alpha or AdVP).
  • This patient may have had an underlying bipotential blastic clone that evolved differently in response to IFN-alpha or AdVP.
  • In some CML patients, IFN-alpha may induce lymphoid blast crisis.
  • [MeSH-major] Blast Crisis / chemically induced. Interferon-alpha / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • [MeSH-minor] Clone Cells / drug effects. Clone Cells / pathology. Fatal Outcome. Female. Humans. Middle Aged. Myeloid Cells / drug effects. Myeloid Cells / pathology


11. Kantarjian HM, O'Brien S, Cortes J, Giles FJ, Faderl S, Issa JP, Garcia-Manero G, Rios MB, Shan J, Andreeff M, Keating M, Talpaz M: Results of decitabine (5-aza-2'deoxycytidine) therapy in 130 patients with chronic myelogenous leukemia. Cancer; 2003 Aug 1;98(3):522-8
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  • [Title] Results of decitabine (5-aza-2'deoxycytidine) therapy in 130 patients with chronic myelogenous leukemia.
  • BACKGROUND: General and site-specific DNA methylation is associated with tumor progression and resistance in several cancers, including chronic myelogenous leukemia (CML).
  • Decitabine is a hypomethylating agent that has shown encouraging preliminary anti-CML activity.
  • This study evaluated the activity and toxicity of decitabine in different phases of CML.
  • METHODS: One hundred and thirty patients with CML were treated: 123 with Philadelphia chromosome (Ph)-positive CML (64 blastic, 51 accelerated, 8 chronic) and 7 with Ph-negative CML.
  • Of 64 patients in the CML blastic phase, 18 patients (28%) achieved objective responses.
  • Of seven patients treated for Ph-negative CML, four (57%) had objective responses.
  • The estimated 3-year survival rate was less than 5% in the blastic phase and 27% in the accelerated phase.
  • With decitabine 50-75 mg/m(2), the median time to granulocyte recovery above 0.5 x 10(9)/L was about 4 weeks.
  • CONCLUSIONS: Decitabine appears to have significant anti-CML activity.
  • Future studies should evaluate lower-dose, longer-exposure decitabine schedules alone in imatinib-resistant CML, as well as combinations of decitabine and imatinib in different CML phases.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Azacitidine / analogs & derivatives. Azacitidine / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Blast Crisis. DNA Modification Methylases / antagonists & inhibitors. Drug Administration Schedule. Female. Humans. Male. Middle Aged

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  • [Copyright] Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11543
  • (PMID = 12879469.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 776B62CQ27 / decitabine; EC 2.1.1.- / DNA Modification Methylases; M801H13NRU / Azacitidine
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12. Giles FJ, Cortes JE, Kantarjian HM, O'Brien SM: Accelerated and blastic phases of chronic myelogenous leukemia. Hematol Oncol Clin North Am; 2004 Jun;18(3):753-74, xii
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  • [Title] Accelerated and blastic phases of chronic myelogenous leukemia.
  • Chronic myelogenous leukemia (CML) may have a biphasic or triphasic course, whereby patients who were initially diagnosed in the chronic phase (CP) develop more aggressive disease, frequently pass through an intermediate or accelerated phase (AP), and finally evolve into an acute leukemia like blastic phase (BP).
  • A slowing in the rate of development of AP or BP has accompanied successive improvements in therapy for patients who have CP CML.
  • The management of patients in AP or BP consistently has been less effective than the management of those inCP for all modalities of therapy.
  • This article reviews the current diagnostic criteria, therapeutic strategies, outcomes, and investigational therapies for AP and BP CML.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Blast Crisis / diagnosis. Blast Crisis / drug therapy. Clone Cells / pathology. Humans. Leukemia, Myeloid, Accelerated Phase / diagnosis. Leukemia, Myeloid, Accelerated Phase / drug therapy. Treatment Outcome

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  • (PMID = 15271404.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 177
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13. Auewarakul CU, Huang S, Yimyam M, Boonmoh S: Natural history of Southeast Asian chronic myeloid leukemia patients with different BCR-ABL gene variants. Acta Haematol; 2006;116(2):114-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Natural history of Southeast Asian chronic myeloid leukemia patients with different BCR-ABL gene variants.
  • Little evidence exists regarding the prognostic impact of the major BCR-ABL gene variants (e13a2 and e14a2) in chronic myeloid leukemia (CML) patients diagnosed and treated in the developing Asian countries.
  • In this study, 139 Thai CML patients were followed for a median period of 3 years (range 18-43 months).
  • All patients received oral chemotherapy and 13% underwent allogeneic stem cell transplantation.
  • In the conventional chemotherapy group, the overall survival (OS) rate was slightly better in e14a2+ than in e13a2+ patients (p = n.s.).
  • The type of blastic crisis in e14a2+ and e13a2+ patients was similar, being predominantly myeloid.
  • In conclusion, CML patients in Thailand, despite being much younger, had a comparable OS with those in the Western countries, with no different OS between e14a2+ and e13a2+ patients.
  • Future studies should focus on the impact of novel oral BCR-ABL tyrosine kinase inhibitors on the outcome of Thai CML patients with different BCR-ABL gene variants.
  • [MeSH-major] Fusion Proteins, bcr-abl / genetics. Genes, abl. Genetic Variation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Stem Cell Transplantation. Thailand. Transplantation, Homologous


14. Fang B, Song Y, Han Z, Wei X, Lin Q, Zhu X, Yang R, Sun J, Tian G, Liu X, Cao G, Shi Y, Nie N, Li D, Zhao RC: Synergistic interactions between 12-0-tetradecanoylphorbol-13-acetate (TPA) and imatinib in patients with chronic myeloid leukemia in blastic phase that is resistant to standard-dose imatinib. Leuk Res; 2007 Oct;31(10):1441-4
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  • [Title] Synergistic interactions between 12-0-tetradecanoylphorbol-13-acetate (TPA) and imatinib in patients with chronic myeloid leukemia in blastic phase that is resistant to standard-dose imatinib.
  • We have demonstrated that 12-0-tetradecanoylphorbol-13-acetate (TPA) combined with vitamin D(3) (VD(3)) and cytosine arabinoside (Ara C) is effective and feasible for chronic myelogenous leukemia (CML) in blastic phase (BP).
  • In the current study, the efficacy of TPA combined with inhibitor imatinib mesylate (imatinib) was investigated in patients with CML in BP that was resistant to standard-dose imatinib (400mg/day).
  • So this approach deserves further evaluation as frontline therapy for newly diagnosed CML.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blast Crisis / drug therapy. Drug Resistance, Neoplasm. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • [MeSH-minor] Adult. Benzamides. Drug Synergism. Female. Humans. Imatinib Mesylate. Male. Middle Aged. Piperazines / administration & dosage. Pyrimidines / administration & dosage. Tetradecanoylphorbol Acetate / administration & dosage. Treatment Outcome


15. Kakihana K, Mizuchi D, Yamaguchi M, Sakashita C, Fukuda T, Yamamoto K, Miki T, Tohda S, Koyama T, Murakami N, Miura O: [Hypercalcemia mediated by parathyroid hormone-related protein in the blastic phase of chronic myelogenous leukemia]. Rinsho Ketsueki; 2002 Feb;43(2):102-6
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  • [Title] [Hypercalcemia mediated by parathyroid hormone-related protein in the blastic phase of chronic myelogenous leukemia].
  • A 45-year-old man with chronic myelogenous leukemia (CML) in the accelerated phase was admitted to our hospital because of lower back pain and hypercalcemia.
  • Splenomegaly recurred after cessation of the chemotherapy, and examination of the peripheral blood showed 31% blasts, positive for both CD13 and CD33, on which basis myeloid blastic transformation was diagnosed.
  • Furthermore, RT-PCR analysis revealed that the patient's CML cells expressed PTHrP mRNA, and a high level of PTHrP was detected in the supernatant of cultured mononuclear cells derived from the patient's peripheral blood.
  • Several cases of PTHrP. mediated hypercalcemia associated with CML have been reported previously, and are reviewed here.
  • [MeSH-major] Blast Crisis. Hypercalcemia / etiology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Protein Biosynthesis

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  • (PMID = 11925871.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / PTHLH protein, human; 0 / Parathyroid Hormone-Related Protein; 0 / Proteins
  • [Number-of-references] 8
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16. Hirose Y, Kiyoi H, Iwai M, Yokozawa T, Ito M, Naoe T: Successful treatment with imatinib mesylate of a CML patient in megakaryoblastic crisis with severe fibrosis. Int J Hematol; 2002 Nov;76(4):349-53
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  • [Title] Successful treatment with imatinib mesylate of a CML patient in megakaryoblastic crisis with severe fibrosis.
  • The prognosis of patients with chronic myeloid leukemia in blastic crisis (CML-BC) remains extremely poor, and multiagent chemotherapy regimens commonly used to treat acute leukemia offer only short-term benefits.
  • Therefore, the advent of the novel molecularly targeted anticancer agent imatinib mesylate is a breakthrough in CML therapy.
  • We present a CML patient in megakaryoblastic crisis with severe myelofibrosis, who was treated with imatinib at a dosage of 400 mg/day and achieved complete remission together with a marked regression of myelofibrosis after 1 month.
  • The effect of imatinib on the long-term prognosis remains unclear, although the agent is clearly a promising drug for treating CML-BC even in cases of myelofibrosis.
  • [MeSH-major] Blast Crisis / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / administration & dosage. Primary Myelofibrosis / drug therapy. Pyrimidines / administration & dosage

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  • (PMID = 12463599.001).
  • [ISSN] 0925-5710
  • [Journal-full-title] International journal of hematology
  • [ISO-abbreviation] Int. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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17. Salesi N, Bossone G, Della Longa G, Di Cocco B: [A new drug in the therapy of chronic myeloid leukemia: ST1571]. Minerva Med; 2003 Apr;94(2):71-6
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  • [Title] [A new drug in the therapy of chronic myeloid leukemia: ST1571].
  • The therapy of chronic myeloid leukemia, characterized by the presence of the Philadelphia chromosome in the clonal hematopoietic stem cells, has changed dramatically in the last years with the development of a specific inhibitor of the BCR-ABL tyrosine kinase: tyrosine kinase inhibitor imatinib mesylate (formerly STI571, [Glivec]).
  • The majority (88%) of interferon-alpha-resistant or intolerant patients in chronic-phase CML, achieved a complete hematologic response to imatinib mesylate.
  • Furthermore, 21% of patients in accelerated-phase CML and 13.5% of patients in blastic-phase CML (patient populations with typically poor prognosis before the advent of imatinib mesylate) achieved major cytogenetic responses.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Enzyme Inhibitors / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Benzamides. Blast Crisis / drug therapy. Clinical Trials, Phase I as Topic. Humans. Imatinib Mesylate


18. Larghero J, Leguay T, Mourah S, Madelaine-Chambrin I, Taksin AL, Raffoux E, Bastie JN, Degos L, Berthaud P, Marolleau JP, Calvo F, Chomienne C, Mahon FX, Rousselot P: Relationship between elevated levels of the alpha 1 acid glycoprotein in chronic myelogenous leukemia in blast crisis and pharmacological resistance to imatinib (Gleevec) in vitro and in vivo. Biochem Pharmacol; 2003 Nov 15;66(10):1907-13
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  • [Title] Relationship between elevated levels of the alpha 1 acid glycoprotein in chronic myelogenous leukemia in blast crisis and pharmacological resistance to imatinib (Gleevec) in vitro and in vivo.
  • The Abl tyrosine kinase inhibitor imatinb is becoming a standard for the treatment of chronic myelogenous leukemia (CML).
  • We aimed to investigate if alpha 1 acid glycoprotein (AGP), an acute phase drug binding protein, could be a biological marker for pharmacological resistance to imatinib in nine patients in acute phase CML.
  • No mutation in the adenosine triphosphate domain of Abl were detected before the initiation of imatinib therapy.
  • By using in vitro tests combining various imatinib concentrations (1-10 microM) with purified human AGP (1 and 3 mg/mL), we demonstrate that imatinib-induced apoptosis of K562 or fresh leukemic CML cells is abrogated or reduced.
  • In patients with CML in blastic phase, AGP levels could reflect pharmacological resistance to imatinib, suggesting that increased dosage of imatinib or the use of a competitor to drug binding should be recommended to optimize the therapeutic effect of the drug.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Blast Crisis / pathology. Drug Resistance, Neoplasm / physiology. Orosomucoid / metabolism. Piperazines / pharmacology. Pyrimidines / pharmacology
  • [MeSH-minor] Apoptosis. Benzamides. Humans. Imatinib Mesylate. K562 Cells. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Tumor Cells, Cultured

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  • (PMID = 14599548.001).
  • [ISSN] 0006-2952
  • [Journal-full-title] Biochemical pharmacology
  • [ISO-abbreviation] Biochem. Pharmacol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Orosomucoid; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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19. Cortes J, Albitar M, Thomas D, Giles F, Kurzrock R, Thibault A, Rackoff W, Koller C, O'Brien S, Garcia-Manero G, Talpaz M, Kantarjian H: Efficacy of the farnesyl transferase inhibitor R115777 in chronic myeloid leukemia and other hematologic malignancies. Blood; 2003 Mar 1;101(5):1692-7
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  • [Title] Efficacy of the farnesyl transferase inhibitor R115777 in chronic myeloid leukemia and other hematologic malignancies.
  • We investigated the clinical activity of the farnesyl transferase inhibitor R115777 in 22 patients with chronic myelogenous leukemia (CML) in chronic, accelerated, or blastic phase and in 8 patients with myelofibrosis (MF) and 10 patients with multiple myeloma (MM).
  • Seven patients with CML (6 in chronic phase, 1 in advanced phase) achieved complete or partial hematologic response.
  • Two patients discontinued therapy because of toxicity while in complete hematologic response.
  • Patients who responded to therapy had significantly higher plasma vascular endothelial growth factor (VEGF) concentrations prior to treatment than nonresponders.
  • Plasma concentrations decreased significantly during therapy among responders.
  • R115777 showed clinical activity in patients with CML and MF.
  • [MeSH-major] Alkyl and Aryl Transferases / antagonists & inhibitors. Antineoplastic Agents / therapeutic use. Enzyme Inhibitors / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Multiple Myeloma / drug therapy. Neoplasm Proteins / antagonists & inhibitors. Primary Myelofibrosis / drug therapy. Quinolones / therapeutic use
  • [MeSH-minor] Adult. Aged. Blast Crisis / blood. Blast Crisis / drug therapy. Drug Administration Schedule. Drug Eruptions / etiology. Endothelial Growth Factors / blood. Farnesyltranstransferase. Fatigue / chemically induced. Female. Fibroblast Growth Factor 2 / blood. Hepatocyte Growth Factor / blood. Humans. Intercellular Signaling Peptides and Proteins / blood. Interferon-alpha / blood. Leukemia, Myeloid, Accelerated Phase / blood. Leukemia, Myeloid, Accelerated Phase / drug therapy. Leukemia, Myeloid, Chronic-Phase / blood. Leukemia, Myeloid, Chronic-Phase / drug therapy. Lymphokines / blood. Male. Middle Aged. Nausea / chemically induced. Salvage Therapy. Treatment Outcome. Tumor Necrosis Factor-alpha / analysis. Vascular Endothelial Growth Factor A. Vascular Endothelial Growth Factors

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  • (PMID = 12411300.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 1R21-CA91518A
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Endothelial Growth Factors; 0 / Enzyme Inhibitors; 0 / Intercellular Signaling Peptides and Proteins; 0 / Interferon-alpha; 0 / Lymphokines; 0 / Neoplasm Proteins; 0 / Quinolones; 0 / Tumor Necrosis Factor-alpha; 0 / Vascular Endothelial Growth Factor A; 0 / Vascular Endothelial Growth Factors; 103107-01-3 / Fibroblast Growth Factor 2; 192185-72-1 / tipifarnib; 67256-21-7 / Hepatocyte Growth Factor; EC 2.5.- / Alkyl and Aryl Transferases; EC 2.5.1.29 / Farnesyltranstransferase
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20. Giles FJ, Cortes JE, Baker SD, Thomas DA, O'Brien S, Smith TL, Beran M, Bivins C, Jolivet J, Kantarjian HM: Troxacitabine, a novel dioxolane nucleoside analog, has activity in patients with advanced leukemia. J Clin Oncol; 2001 Feb 01;19(3):762-71
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  • [Title] Troxacitabine, a novel dioxolane nucleoside analog, has activity in patients with advanced leukemia.
  • PURPOSE: To investigate the toxicity profile, activity, and pharmacokinetics of a novel L-nucleoside analog, troxacitabine (BCH-4556), in patients with advanced leukemia.
  • PATIENTS AND METHODS: Patients with refractory or relapsed acute myeloid (AML) or lymphocytic (ALL) leukemia, myelodysplastic syndromes (MDS), or chronic myelogenous leukemia in blastic phase (CML-BP).
  • RESULTS: Forty-two patients (AML: 31 patients; MDS: six patients [five MDS + one CMML]; ALL: four patients; CML-BP: one patient) were treated.
  • Approximately 69% of troxacitabine was excreted as unchanged drug in the urine.
  • A patient with CML-BP achieved a return to chronic phase disease.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Cytosine / adverse effects. Cytosine / analogs & derivatives. Dioxolanes / adverse effects. Leukemia / drug therapy
  • [MeSH-minor] Acute Disease. Adult. Aged. Blast Crisis / drug therapy. Blast Crisis / metabolism. Dose-Response Relationship, Drug. Female. Humans. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / metabolism. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Leukemia, Myeloid / drug therapy. Leukemia, Myeloid / metabolism. Male. Middle Aged. Myelodysplastic Syndromes / drug therapy. Myelodysplastic Syndromes / metabolism. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism

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  • (PMID = 11157029.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Dioxolanes; 60KQZ0388Y / troxacitabine; 8J337D1HZY / Cytosine
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21. Bulum J, Labar B, Mikulić M, Bogdanić V, Sertić D, Nemet D, Krecak-Gverić V, Kovacević J, Serventi-Seiwerth R, Mrsić-Davidović S, Zadro R, Boban D: [Treatment of chronic myeloid leukemia with imatinib in the accelerated stage of the disease]. Lijec Vjesn; 2003 Jul-Aug;125(7-8):176-9
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  • [Title] [Treatment of chronic myeloid leukemia with imatinib in the accelerated stage of the disease].
  • Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML), in advanced stage of disease, is resistant to standard chemotherapy.
  • Nine of them were in accelerated phase and 6 in blastic crisis of Ph+ CML.
  • After a 9-month follow up Ph+ CML progressed in 9 patients (60%) and 4 of them died.
  • Imatinib mesylate has a substantial, but short term activity in the accelerated phase and blastic crisis of the Ph+ CML.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Enzyme Inhibitors / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Protein-Tyrosine Kinases / antagonists & inhibitors. Pyrimidines / therapeutic use


22. Lee SA, Lim J, Kim M, Kim Y, Han K: [A case of t(3;3)(q21;q26.2) associated with severe multilineage dysplasia and multi-drug resistance in blastic crisis of chronic myelogenous leukemia]. Korean J Lab Med; 2010 Dec;30(6):595-9
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  • [Title] [A case of t(3;3)(q21;q26.2) associated with severe multilineage dysplasia and multi-drug resistance in blastic crisis of chronic myelogenous leukemia].
  • Patients with these cytogenetic abnormalities show extremely poor prognosis even with aggressive anti-leukemic therapy.
  • We report a case of blastic crisis of CML with both t(3;3)(q21;q26.2) and t(9;22)(q34;q11.2) and associated severe multilineage dysplasia.
  • The patient showed a poor response to imatinib, dasatinib and aggressive induction therapy.
  • When both t(3;3)(q21;q26.2) and t(9;22)(q34;q11.2) are observed in cases of leukemia with increased blasts, they are best considered as aggressive phases of CML with t(3;3)(q21;q26.2), rather than AML with t(9;22)(q34;q11.2) by 2008 WHO classification.
  • [MeSH-major] Blast Crisis / diagnosis. Chromosomes, Human, Pair 3. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis. Translocation, Genetic
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Benzamides. Bone Marrow Cells / pathology. Dasatinib. Drug Resistance, Neoplasm. Humans. Imatinib Mesylate. Karyotyping. Male. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Thiazoles / therapeutic use

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  • (PMID = 21157145.001).
  • [ISSN] 1598-6535
  • [Journal-full-title] The Korean journal of laboratory medicine
  • [ISO-abbreviation] Korean J Lab Med
  • [Language] kor
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 0 / Thiazoles; 8A1O1M485B / Imatinib Mesylate; RBZ1571X5H / Dasatinib
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23. Matsuo T, Tomonaga M: [Chemotherapy and radiation therapy]. Nihon Rinsho; 2001 Dec;59(12):2364-8
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  • [Title] [Chemotherapy and radiation therapy].
  • Stem cell transplantation and interferon-based treatment are major strategies in chronic phase CML and chemotherapy is one of limited therapeutic options when they are not available or ineffective.
  • Homoharringtonine, a plant alkaloid, has shown cytogenetic response in one third of patients who were resistant to interferon therapy, and a better response rate in combination with cytarabine and interferon alfa.
  • There have been no improvement of clinical outcome in treatment of accelerated phase and blastic crisis although many trials including decitabine are going on.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Azacitidine / analogs & derivatives. Hydroxyurea / therapeutic use. Leukemia, Myeloid, Chronic-Phase / drug therapy. Leukemia, Myeloid, Chronic-Phase / radiotherapy
  • [MeSH-minor] Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Agents, Alkylating / therapeutic use. Antineoplastic Agents, Phytogenic / therapeutic use. Busulfan / therapeutic use. Harringtonines / therapeutic use. Humans

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  • (PMID = 11766340.001).
  • [ISSN] 0047-1852
  • [Journal-full-title] Nihon rinsho. Japanese journal of clinical medicine
  • [ISO-abbreviation] Nippon Rinsho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Phytogenic; 0 / Harringtonines; 6FG8041S5B / homoharringtonine; 776B62CQ27 / decitabine; G1LN9045DK / Busulfan; M801H13NRU / Azacitidine; X6Q56QN5QC / Hydroxyurea
  • [Number-of-references] 13
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24. Dutcher JP, Wiernik PH: Accelerated and blastic phase of chronic myeloid leukemia. Curr Treat Options Oncol; 2000 Apr;1(1):51-62
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  • [Title] Accelerated and blastic phase of chronic myeloid leukemia.
  • There is currently no standard treatment for the blastic phase of chronic myeloid leukemia (CML-BC), which is a chemoresistant form of acute leukemia.
  • Current approaches include using standard acute myeloid leukemia (AML) regimens in an effort to induce remission, variations of these approaches with drugs that seem more active in this specific leukemia, and the direct entry of patients into studies of investigational agents.
  • Although the likelihood of achieving remission is small, immediate bone marrow transplantation in remission should be considered because it provides the only opportunity for long-term survival at this time.
  • Often, however, the duration of chemotherapy-induced remission of blast crisis is very short and may preclude entry into a transplant program.
  • Again, there is no standard treatment, and clinical trials are recommended as first-line therapy.
  • Treatment in the accelerated phase includes standard AML chemotherapy regimens, combinations of new agents, and the combination of cytostatic agents with interferon.
  • Patients whose accelerated phase reverts to chronic phase after treatment may become candidates for bone marrow transplantation.
  • [MeSH-major] Blast Crisis / therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Transplantation. Combined Modality Therapy. Diet. Humans. Life Style. Middle Aged. Radiotherapy. Survival Rate. Treatment Outcome


25. Morimoto A, Ogami A, Chiyonobu T, Takanashi M, Sugimoto T, Imamura T, Ishida H, Yoshihara T, Imashuku S: Early blastic transformation following complete cytogenetic response in a pediatric chronic myeloid leukemia patient treated with imatinib mesylate. J Pediatr Hematol Oncol; 2004 May;26(5):320-2
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  • [Title] Early blastic transformation following complete cytogenetic response in a pediatric chronic myeloid leukemia patient treated with imatinib mesylate.
  • This article reports early blastic transformation of chronic myeloid leukemia (CML) in a child following a complete cytogenetic response induced by imatinib mesylate.
  • A 14-year-old Japanese boy was diagnosed with t(9;22) cryptic CML in the chronic phase and treated with imatinib.
  • His response to treatment was slow, but a major cytogenetic response was obtained at 142 days of therapy.
  • However, he developed lymphoid blastic transformation at 9 months.
  • He attained remission with acute lymphoblastic leukemia-type chemotherapy and then successfully received a non-T-cell-depleted allogeneic stem cell transplantation (allo-SCT) with his mother's two loci-mismatched donor cells.
  • A sudden blastic transformation may occur even with a complete cytogenetic response induced by imatinib.
  • CML patients who respond slowly to imatinib may still be candidates for allo-SCT, even when a major cytogenetic response is obtained.
  • [MeSH-major] Blast Crisis / therapy. Leukemia, Myeloid, Chronic-Phase / drug therapy. Lymphocyte Activation. Piperazines / therapeutic use. Pyrimidines / therapeutic use

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  • (PMID = 15111787.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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26. Turgut B, Vural O, Demir M, Kaldir M: Candida arthritis in a patient with chronic myelogenous leukemia (CML) in blastic transformation, unresponsive to fluconazole, but treated effectively with liposomal amphotericin B. Ann Hematol; 2002 Sep;81(9):529-31
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  • [Title] Candida arthritis in a patient with chronic myelogenous leukemia (CML) in blastic transformation, unresponsive to fluconazole, but treated effectively with liposomal amphotericin B.
  • We report a case of Candida arthritis, which occurred in a patient with chronic myelogenous leukemia (CML) in blastic transformation.
  • Aggressive chemotherapy and broad-spectrum antibiotics for a prolonged period for febrile neutropenia had been given to the patient.
  • Despite treatment with fluconazole, no clinical or microbiological improvement was obtained.
  • [MeSH-major] Amphotericin B / administration & dosage. Arthritis, Infectious / drug therapy. Candidiasis / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications. Phosphatidylcholines / administration & dosage. Phosphatidylglycerols / administration & dosage
  • [MeSH-minor] Blast Crisis. Drug Combinations. Drug Resistance. Fatal Outcome. Female. Fluconazole / administration & dosage. Humans. Middle Aged. Opportunistic Infections / drug therapy. Opportunistic Infections / etiology

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  • (PMID = 12373355.001).
  • [ISSN] 0939-5555
  • [Journal-full-title] Annals of hematology
  • [ISO-abbreviation] Ann. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Phosphatidylcholines; 0 / Phosphatidylglycerols; 0 / liposomal amphotericin B; 7XU7A7DROE / Amphotericin B; 8VZV102JFY / Fluconazole
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27. Kwatra KS, Prabhakar BR, Arora Y: Bilateral granulocytic sarcoma (chloroma) of the breast in CML in blast crisis: a case report. Indian J Pathol Microbiol; 2004 Jan;47(1):66-8
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  • [Title] Bilateral granulocytic sarcoma (chloroma) of the breast in CML in blast crisis: a case report.
  • A 35 year old lady was diagnosed as having chronic myeloid leukemia in May 1999 and thereafter started on chemotherapy.
  • The peripheral blood picture showed blastic transformation.
  • [MeSH-major] Blast Crisis / pathology. Breast Neoplasms / pathology. Sarcoma, Myeloid / pathology

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  • (PMID = 15471137.001).
  • [ISSN] 0377-4929
  • [Journal-full-title] Indian journal of pathology & microbiology
  • [ISO-abbreviation] Indian J Pathol Microbiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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28. Altintas A, Cil T, Kilinc I, Kaplan MA, Ayyildiz O: Central nervous system blastic crisis in chronic myeloid leukemia on imatinib mesylate therapy: a case report. J Neurooncol; 2007 Aug;84(1):103-5
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  • [Title] Central nervous system blastic crisis in chronic myeloid leukemia on imatinib mesylate therapy: a case report.
  • Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by a reciprocal translocation between chromosomes 9 and 22.
  • Imatinib is a first choice of treatment of chronic phase CML.
  • It has also shown activity in patients with CML in accelerated or blastic phases.
  • However, the penetration of the drug and its active metabolites into the central nervous system (CNS) is poor.
  • Herein, we report a patient with CML in accelerated phase that developed central nervous system disease while on imatinib mesylate therapy.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Blast Crisis / drug therapy. Central Nervous System Neoplasms / secondary. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Sarcoma, Myeloid / drug therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Benzamides. Blood-Brain Barrier / drug effects. Blood-Brain Barrier / metabolism. Cytarabine / administration & dosage. Dexamethasone / administration & dosage. Humans. Imatinib Mesylate. Magnetic Resonance Imaging. Male. Methotrexate / administration & dosage. Protein-Tyrosine Kinases / antagonists & inhibitors. Treatment Outcome


29. Raiola AM, Van Lint MT, Valbonesi M, Lamparelli T, Gualandi F, Occhini D, Bregante S, di Grazia C, Dominietto A, Soracco M, Romagnani C, Vassallo F, Casini M, Bruno B, Frassoni F, Bacigalupo A: Factors predicting response and graft-versus-host disease after donor lymphocyte infusions: a study on 593 infusions. Bone Marrow Transplant; 2003 Apr;31(8):687-93
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  • Patients were analyzed after stratification for type of relapse: (1).
  • chronic phase of chronic myeloid leukemia (CML) or complete remission of other disease post chemotherapy (n=24), (4).
  • CML in accelerated/blastic phase (n=14), (5).
  • resistant disease not responding to chemotherapy (n=36).
  • Factors predicting response by multivariate analysis were type of relapse (P<0.0001), post-DLI GvHD (P=0.005), pancytopenia (P=0.008), and a diagnosis of CML (P=0.04).
  • The actuarial probability of treatment-related mortality was 9% for HLA identical siblings and 44% for alternative donor transplants (P=0.006).
  • [MeSH-major] Bone Marrow Transplantation / immunology. Graft vs Host Disease / epidemiology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Lymphocyte Transfusion. Transplantation, Homologous
  • [MeSH-minor] Adolescent. Adult. Aged. Antigens, CD / blood. Antigens, CD3 / blood. Blast Crisis / therapy. Female. Humans. Male. Middle Aged. Predictive Value of Tests. Probability. Prognosis. Recurrence. Retrospective Studies

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  • (PMID = 12692609.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Antigens, CD3
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30. Zang C, Liu H, Waechter M, Eucker J, Bertz J, Possinger K, Koeffler HP, Elstner E: Dual PPARalpha/gamma ligand TZD18 either alone or in combination with imatinib inhibits proliferation and induces apoptosis of human CML cell lines. Cell Cycle; 2006 Oct;5(19):2237-43
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  • [Title] Dual PPARalpha/gamma ligand TZD18 either alone or in combination with imatinib inhibits proliferation and induces apoptosis of human CML cell lines.
  • Despite progress in the treatment of early-stage chronic myeloid leukemia (CML), the accelerated and blastic phases of CML still remain a therapeutic challenge.
  • Persistence of BCR-ABL-positive (bcr-abl(+)) cells or secondary resistance during imatinib therapy frequently occurs.
  • In this study, we investigated the activity of a novel dual ligand specific for peroxisome proliferator-activated receptor alpha and gamma (PPARalpha/gamma) against CML blast crisis cell lines.
  • Exposure of these cell lines (K562, KU812 and KCL22) to TZD18 resulted in a growth inhibition in a dose- and time-dependent manner.
  • Overall, our findings strongly suggest that either TZD18, either alone or in combination with imatinib may be beneficial for the treatment of CML in myeloid blast crisis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / pharmacology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Phenyl Ethers / pharmacology. Piperazines / pharmacology. Pyrimidines / pharmacology. Thiazolidinediones / pharmacology
  • [MeSH-minor] Apoptosis / drug effects. Benzamides. Cell Line, Tumor. Cell Proliferation / drug effects. Drug Synergism. Humans. Imatinib Mesylate. PPAR alpha / agonists. PPAR gamma / agonists

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  • (PMID = 17102607.001).
  • [ISSN] 1551-4005
  • [Journal-full-title] Cell cycle (Georgetown, Tex.)
  • [ISO-abbreviation] Cell Cycle
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / 5-(3-(3-(4-phenoxy-2-propylphenoxy)propoxy)phenyl)-2,4-thiazolidinedione; 0 / Benzamides; 0 / PPAR alpha; 0 / PPAR gamma; 0 / Phenyl Ethers; 0 / Piperazines; 0 / Pyrimidines; 0 / Thiazolidinediones; 8A1O1M485B / Imatinib Mesylate
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31. Hamaki T, Kami M, Momomura S, Mineishi S, Kusumi E, Kanda Y, Ueyama J, Miyakoshi S, Morinaga S, Takaue Y, Mutou Y: Sustained molecular remission in a patient with CML in blastic crisis receiving dose-reduced hematopoietic stem-cell transplantation followed by early withdrawal of cyclosporine and prophylactic use of interferon-alpha. Am J Hematol; 2002 Nov;71(3):196-9
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  • [Title] Sustained molecular remission in a patient with CML in blastic crisis receiving dose-reduced hematopoietic stem-cell transplantation followed by early withdrawal of cyclosporine and prophylactic use of interferon-alpha.
  • A 54-year-old man with chronic myelocytic leukemia in blastic phase received reduced-intensity transplantation (RIST) from an HLA-identical unrelated donor.
  • To induce GVHD and augment a graft-versus-leukemia effect, we initiated interferon-alpha therapy on day 80 to a maximum dosage of three million units five times a week.
  • This case suggests that early withdrawal of cyclosporine and the prophylactic use of interferon-alpha are promising in RIST for high-risk leukemia.
  • [MeSH-major] Blast Crisis / surgery. Cyclosporine / administration & dosage. Hematopoietic Stem Cell Transplantation / methods. Immunosuppressive Agents / administration & dosage. Interferon-alpha / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery. Neoplasm Recurrence, Local / prevention & control
  • [MeSH-minor] Drug Administration Schedule. Graft vs Host Disease / physiopathology. Graft vs Host Disease / prevention & control. Humans. Male. Middle Aged. Remission Induction

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • (PMID = 12410575.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 0 / Interferon-alpha; 83HN0GTJ6D / Cyclosporine
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32. Takahashi N, Maruta A, Hashimoto C, Kato K, Tanabe J, Kodama F, Oba R, Harada H, Omine M: [Successful allogeneic bone marrow transplantation following fungal liver abscess treatment in a patient with chronic myeloid leukemia in blastic crisis]. Rinsho Ketsueki; 2000 Dec;41(12):1247-53
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  • [Title] [Successful allogeneic bone marrow transplantation following fungal liver abscess treatment in a patient with chronic myeloid leukemia in blastic crisis].
  • A 40-year-old man was diagnosed as having chronic myeloid leukemia (CML) in December 1990 and received busulfan and hydroxyurea.
  • He developed myeloid blast crisis in February 1996.
  • After DCMP combination chemotherapy, his disease reverted to chronic phase, but right hypochondrial pain developed and low-grade fever persisted.
  • Acute grade III GVHD developed, but there was no evidence of reactivation of the liver abscesses.
  • This case demonstrates that a prior fungal liver abscess is not an absolute contraindication for BMT if prophylactic antifungal drugs are administered and careful observation is conducted.
  • [MeSH-major] Blast Crisis. Bone Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Liver Abscess / drug therapy. Mycoses / drug therapy
  • [MeSH-minor] Adult. Amphotericin B / administration & dosage. Antifungal Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Fluconazole / therapeutic use. Humans. Male. Transplantation, Homologous


33. Alimena G, Breccia M, Latagliata R, Carmosino I, Russo E, Biondo F, Diverio D, Mancini M, Nanni M, Mandelli F: Sudden blast crisis in patients with Philadelphia chromosome-positive chronic myeloid leukemia who achieved complete cytogenetic remission after imatinib therapy. Cancer; 2006 Sep 1;107(5):1008-13
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  • [Title] Sudden blast crisis in patients with Philadelphia chromosome-positive chronic myeloid leukemia who achieved complete cytogenetic remission after imatinib therapy.
  • BACKGROUND: Most patients with Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML) in chronic phase (CP) who receive treatment with imatinib achieve complete cytogenetic remission (CCR), which is correlated tightly with long-term progression-free survival.
  • In these patients, the occurrence of blastic crisis (BC) is rare, and its clinical biologic characteristics are not well known.
  • METHODS: Among 164 patients who received imatinib and were followed for a median of 35 months, 11 patients (6.7%) developed a BC; this was sudden (i.e., it occurred within 3 months of a documented CCR) in 6 patients (54.5%).
  • RESULTS: At the time of diagnosis, there were 3 low-risk patients and 3 intermediate-risk patients; 4 patients had received pretreatment with interferon, and 2 patients received only imatinib.
  • The median CP was 18 months, and the median duration of imatinib therapy was 7 months.
  • The median time to CCR was 3 months, and the median time from CCR to BC was 4 months.
  • CONCLUSIONS: Sudden BC generally is an uncommon phenomenon that may be relatively frequent in patients with CML who receive imatinib.
  • Clinical and biologic features also seem to characterize this peculiar type of abrupt disease evolution, which intervenes in patients' response to this drug.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Blast Crisis. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Piperazines / therapeutic use. Pyrimidines / therapeutic use


34. Karbasian Esfahani M, Morris EL, Dutcher JP, Wiernik PH: Blastic phase of chronic myelogenous leukemia. Curr Treat Options Oncol; 2006 May;7(3):189-99
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  • [Title] Blastic phase of chronic myelogenous leukemia.
  • Chronic myelogenous leukemia (CML), also known as chronic myelocytic or chronic myeloid leukemia, is a clonal disorder of hematopoiesis that arises in a hematopoietic stem cell or early progenitor cell.
  • Eventually, in spite of the term chronic, there is progression to acute leukemia, usually of the myeloid variety, which is highly resistant to current therapies.
  • Despite recent improvements in the treatment of early-stage disease, CML blast crisis (CMLBC) remains a therapeutic challenge.
  • CMLBC is highly refractory to standard induction chemotherapy, with a response rate in myeloid blast crisis of less than 30%.
  • Conventional chemotherapy has been much less successful in this disease compared with de novo acute leukemia, with a mean survival after diagnosis of blast crisis of only 2 to 4 months for nonresponders.
  • Although imatinib was evaluated in patients with CMLBC, most CMLBC cases today arise in patients already on imatinib-based therapy and developing blastic phase on that therapy; thus there is no standard therapy for patients with CMLBC.
  • Further studies of the mechanisms of transformation of chronic-phase CMLBC at a molecular level, and methods to target these molecular abnormalities, will determine the future direction of new treatment modalities.
  • The prognosis of CML in blast crisis remains disappointing, despite great efforts.
  • Currently, the most successful strategy for improving survival in CML is by prolonging the chronic phase and delaying the onset of blast crisis.
  • [MeSH-major] Blast Crisis / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology

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  • (PMID = 16615875.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 60
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35. Axdorph U, Stenke L, Grimfors G, Carneskog J, Hansen J, Linder O, Ljungman P, Löfvenberg E, Malm C, Simonsson B, Turesson I, Vilén L, Udén AM, Björkholm M, Swedish CML Group: Intensive chemotherapy in patients with chronic myelogenous leukaemia (CML) in accelerated or blastic phase--a report from the Swedish CML Group. Br J Haematol; 2002 Sep;118(4):1048-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intensive chemotherapy in patients with chronic myelogenous leukaemia (CML) in accelerated or blastic phase--a report from the Swedish CML Group.
  • In attempting to restore the chronic phase (CP) of chronic myelogenous leukaemia (CML), the Swedish CML group utilized an intensive chemotherapy protocol for 83 patients (aged 16-79 years) in accelerated (AP, n = 22) or blastic phase (BC, n = 61).
  • Responding patients < 65 years were eligible for ablative chemotherapy followed by an allogeneic (SCT) or a double autologous stem cell transplant (ASCT).
  • In conclusion, approximately half of the patients achieved a CP2/PR after intensive chemotherapy, with a clear survival advantage for responders vs non-responders.
  • Novel therapeutic options for CML patients in AP/BP are needed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Blast Crisis. Combined Modality Therapy. Cytarabine / administration & dosage. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Mitoxantrone / administration & dosage. Prognosis. Remission Induction. Statistics, Nonparametric. Stem Cell Transplantation. Survival Rate

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  • (PMID = 12199784.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; 6PLQ3CP4P3 / Etoposide; BZ114NVM5P / Mitoxantrone
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36. Sugiyama K, Usui N, Asai O, Saito T, Yano S, Okawa Y, Takahara S, Takei Y, Uno S, Dobashi N, Kobayashi M: [Successful induction of complete cytogenetic response with high-dose imatinib mesylate and subsequent allogeneic stem cell transplantation for CML blastic crisis]. Rinsho Ketsueki; 2003 Jun;44(6):386-90
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  • [Title] [Successful induction of complete cytogenetic response with high-dose imatinib mesylate and subsequent allogeneic stem cell transplantation for CML blastic crisis].
  • We diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia (CML) in a blast crisis and started imatinib mesylate therapy at a dose of 800 mg/day on March 9th, 2002.
  • This case suggested the usefulness of imatinib mesylate in the management of the CML-associated blast crisis.
  • [MeSH-major] Blast Crisis / therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Peripheral Blood Stem Cell Transplantation. Piperazines / administration & dosage. Pyrimidines / administration & dosage
  • [MeSH-minor] Adult. Benzamides. Combined Modality Therapy. Humans. Imatinib Mesylate. Male. Pulse Therapy, Drug. Remission Induction. Treatment Outcome

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  • (PMID = 12884817.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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37. Robak T, Góra-Tybor J: Cladribine combined with mitoxantrone in the treatment of blastic phase of chronic myeloid leukemia. Neoplasma; 2001;48(3):203-7
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  • [Title] Cladribine combined with mitoxantrone in the treatment of blastic phase of chronic myeloid leukemia.
  • A phase II clinical study was performed to evaluate the effectiveness and toxicity of cladribine (2-CdA) combined with mitoxantrone (CM regimen) in the treatment of chronic myeloid leukemia in blastic phase (CML BP).
  • A total of 12 adult patients with CML BP were included in this study.
  • Infections occurred in 4 patients (33.3%) and 2 of them died of sepsis shortly after CM treatment.
  • This preliminary results in a small group of patients suggest that CM programme has limited value in pre-treated patients with CML BP.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cladribine / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Mitoxantrone / therapeutic use
  • [MeSH-minor] Adult. Aged. Blast Crisis / drug therapy. Drug Administration Schedule. Female. Humans. Infusions, Intravenous. Male. Middle Aged. Treatment Outcome


38. Kroschinsky F, Friedrich K, Hanel M, Mohr B, Langer T, Meinhardt M, Thiede C, Bornhauser M, Baretton G, Ehninger G: Extramedullary blast crisis of chronic myeloid leukemia after allogeneic hematopoietic stem cell transplantation mimicking aggressive, translocation t(14;18)-positive B-cell lymphoma. Ann Hematol; 2003 Jan;82(1):47-52
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  • [Title] Extramedullary blast crisis of chronic myeloid leukemia after allogeneic hematopoietic stem cell transplantation mimicking aggressive, translocation t(14;18)-positive B-cell lymphoma.
  • We report the case of a 42-year-old male patient who was diagnosed with a large tumor of the right thoracic aperture 30 months after unrelated hematopoietic stem cell transplantation (HSCT) for accelerated phase of Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML).
  • Biopsy revealed an immature lymphoid neoplasia with blastic tumor cell morphology and immunoreactivity for CD34, CD79a, CD43, and CD30 as well as slight positivity for TdT and CD20.
  • Neither radiation nor intensive chemotherapy was capable of achieving a tumor remission, and the patient died from progressive disease 6 months later.
  • We conclude that lymphoid neoplasia occurring in our patient should be interpreted as an extramedullary, very immature blast crisis of CML expressing lymphoid differentiation markers rather than a true de novo NHL.
  • [MeSH-major] Blast Crisis / diagnosis. Chromosomes, Human, Pair 14. Chromosomes, Human, Pair 18. Hematopoietic Stem Cell Transplantation. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Lymphoma, B-Cell / diagnosis. Lymphoma, B-Cell / genetics. Thoracic Neoplasms / diagnosis. Thoracic Neoplasms / genetics. Translocation, Genetic


39. Wadhwa J, Szydlo RM, Apperley JF, Chase A, Bua M, Marin D, Olavarria E, Kanfer E, Goldman JM: Factors affecting duration of survival after onset of blastic transformation of chronic myeloid leukemia. Blood; 2002 Apr 1;99(7):2304-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Factors affecting duration of survival after onset of blastic transformation of chronic myeloid leukemia.
  • We analyzed factors having an impact on response to treatment and survival in 78 consecutive patients with chronic myeloid leukemia (CML) in blastic transformation (BT) referred to the Hammersmith Hospital from January 1995 to December 2000.
  • BT was defined as the presence of at least 30% blasts in blood or marrow or extramedullary blastic deposits.
  • Initial treatment varied; 41 patients received cytotoxic drugs, 8 underwent allogeneic or autologous transplantation procedures, 21 received STI571 (imatinib mesylate, Gleevec), 1 received radiotherapy, and 7 received no therapy.
  • Of the 25 (32%) patients who achieved a "second chronic phase" with first therapy, 6 of 21 (29%) were treated with STI571 and 19 of 50 (38%) were treated with chemotherapy, transplantation, or radiotherapy.
  • Patients who achieved a second chronic phase survived longer than those who did not (median time from onset of BT 12.0 months versus 6.3 months, P =.0004).
  • We speculate that the combined use of STI571 with cytotoxic drugs may offer additional benefit.
  • [MeSH-major] Blast Crisis / mortality. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / therapeutic use. Child. Disease-Free Survival. Humans. Leukocyte Count. Middle Aged. Platelet Count. Predictive Value of Tests. Prognosis. Survival Rate. Time Factors


40. Lewandowski K, Warzocha K, Hellmann A, Skotnicki A, Prejzner W, Foryciarz K, Sacha T, Gniot M, Majewski M, Solarska I, Nowak G, Wasag B, Kobelski M, Scibiorski C, Siemiatkowski M, Lewandowska M, Komarnicki M: Frequency of BCR-ABL gene mutations in Polish patients with chronic myeloid leukemia treated with imatinib: a final report of the MAPTEST study. Pol Arch Med Wewn; 2009 Dec;119(12):789-94
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  • [Title] Frequency of BCR-ABL gene mutations in Polish patients with chronic myeloid leukemia treated with imatinib: a final report of the MAPTEST study.
  • INTRODUCTION: The presence of BCR-ABL oncogene mutations in patients with chronic myeloid leukemia (CML) may be responsible for the failure of tyrosine kinase inhibitor treatment.
  • OBJECTIVES: The aim of the study was to evaluate the frequency of BCR-ABL gene mutations in patients with CML (the MAPTEST study) treated with imatinib (IM).
  • The mean time of IM treatment was 18 months.
  • At the time of the analysis, 75 patients were in the first chronic phase (CP), 4 in the second CP, 5 in the acceleration and 8 in the blastic phase.
  • Inclusion criteria were based on the European Leukemia Net definitions for failure and suboptimal response to IM.
  • RESULTS: Twelve mutations were detected in 11 of 92 patients, including 4 mutations (36.7%) diagnosed during CP, 3 (27.3%) in acceleration, and 4 (36.7%) in blast crisis.
  • In 1 patient with lymphoid blast crisis of CML coexisting F359V and Y253F mutations were detected.
  • CONCLUSIONS: The study confirmed the usefulness of BCR-ABL gene mutation screening in patients with CML resistant to IM therapy.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Drug Resistance, Neoplasm / genetics. Fusion Proteins, bcr-abl / genetics. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Piperazines / therapeutic use. Protein Kinase Inhibitors / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adult. Aged. Benzamides. Chromatography, High Pressure Liquid. DNA Mutational Analysis. Dose-Response Relationship, Drug. Female. Gene Expression Regulation, Leukemic. Humans. Imatinib Mesylate. Male. Middle Aged. Neoplasm Staging. Poland. Treatment Outcome. Young Adult






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