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The Oncologist, Vol. 11, No. 8, 929-943, September 2006; doi:10.1634/theoncologist.11-8-929
© 2006 AlphaMed Press

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 Advances in the Therapy of Chronic Idiopathic Myelofibrosis
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Myelomas

Advances in the Therapy of Chronic Idiopathic Myelofibrosis

Cecilia Arana-Yia, Alfonso Quintás-Cardamac, Francis Gilesc, Deborah Thomasc, Antonio Carrasco-Yalanb, Jorge Cortesc, Hagop Kantarjianc, Srdan Verstovsekc

a Departments of Internal Medicine and b Oncology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; c Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

Key Words. Myelofibrosis • Myeloproliferative disorders • Therapy

Correspondence: Srdan Verstovsek, M.D., Ph.D., M.D. Anderson Cancer Center, Department of Leukemia, Unit 428, Houston, Texas 77230, USA. Telephone: 713-745-3429; Fax: 713-794-4297; e-mail: sverstov{at}mdanderson.org

The molecular basis of chronic idiopathic myelofibrosis (CIMF) has remained elusive, thus hampering the development of effective targeted therapies. However, significant progress regarding the molecular mechanisms involved in the pathogenes is of this disease has been made in recent years that will likely provide ample opportunity for the investigation of novel therapeutic approaches. At the fore front of these advances is the discovery that 35%–55% of patients with CIMF harbor mutations in the Janus kinase 2 tyrosine kinase gene. Until very recently, the management of patients with CIMF involved the use of supportive measures, including growth factors, transfusions, or interferon, and the administration of cyto-reductive agents, such as hydroxyurea and anagrelide. However, several trials have demonstrated the efficacy of antiangiogenic agents alone or in combination with corticosteroids. In addition, the use of reduced-intensity conditioning allogeneic stem cell transplantation has resulted in prolonged survival and lower transplant-related mortality.






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