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First Published Online February 2, 2010
The Oncologist, Vol. 15, No. 2, 182-186, February 2010; doi:10.1634/theoncologist.2009-0297
© 2010 AlphaMed Press

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Leukemias

Why Doesn't Imatinib Cure Chronic Myeloid Leukemia?

Robert L. Redner

University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA

Key Words. Chronic myeloid leukemia • CML • Imatinib • Leukemic stem cell

Correspondence: Robert L. Redner, M.D., 2.18A Hillman Research Pavilion, 5117 Centre Avenue, Pittsburgh Pennsylvania 15213, USA. Telephone:412-623-3257; Fax:412-623-7768; e-mail: redner{at}pitt.edu

Received November 24, 2009; accepted for publication January 11, 2010; first published online in THE ONCOLOGIST Express on February 2, 2010.

Disclosures: Robert L. Redner: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the author or independent peer reviewers.

Imatinib mesylate has transformed the treatment for chronic myeloid leukemia (CML). The vast majority of patients obtain hematologic remission, with a low probability of progression of disease. Yet imatinib rarely cures CML, and current recommendations dictate lifelong treatment with imatinib. In this review we analyze the biology behind the failure of imatinib to fully eradicate CML. We review evidence that indicates that the leukemic stem cell for CML is inherently resistant to imatinib, and that imatinib treatment itself may enhance this resistance.


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