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Susan O'Brien, Ellin Berman, Joseph O. Moore, Javier Pinilla-Ibarz, Jerald P. Radich, Paul J. Shami, B. Douglas Smith, David S. Snyder, Hema M. Sundar, Moshe Talpaz and Meir Wetzler

occur in the transition from chronic to accelerated phase. 2 Most cases of CML in the United States are diagnosed in the chronic phase. Untreated CML typically progresses from chronic phase through an accelerated phase at a median of approximately 4

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Scott M. Lindhorst, Richard D. Lopez and Ronald D. Sanders

chronic phase, accelerated phase, or blast crisis Discuss treatment strategies and monitoring of response to isolated CNS disease in patients with CML Many effective therapeutic options are available for patients with chronic myelogenous leukemia

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Jerald P. Radich

with chronic-phase disease from progressing to accelerated phase/blast crisis. “There is a point of no return in CML biology,” he declared ( Figure 1 ). In fact, most cases of progression to accelerated phase/blast crisis in the IRIS trial occurred

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Chronic myelogenous leukemia (CML) accounts for 15% of adult leukemias. In 2005, an estimated 4,600 cases will be diagnosed, and 850 patients will die of the disease. The median age of disease onset is 53 years; however, CML occurs in all age groups, with an increasing proportion of younger patients in more recent series. ML progresses from a chronic phase to a rapidly fatal blastic phase, generally over 3 to 5 years. The blast phase is often preceded by a transition period, called the accelerated phase, which is marked by the acquisition of new cytogenetic abnormalities in 50% to 80% of patients. Several definitions of the accelerated phase of the disease are summarized.

For the most recent version of the guidelines, please visit NCCN.org

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Chronic myelogenous leukemia (CML) accounts for 15% of adult leukemias. In 2003, an estimated 4,300 cases will be diagnosed, and 1,700 patients will die from the disease. The median age of patients with the disease is 53, but CML occurs in all age groups, with an increasing proportion of younger patients in more recent studies. CML progresses from a chronic phase to a rapidly fatal blastic phase, generally over 3 to 5 years. The blast phase is often preceded by a transition period, called the accelerated phase, which is marked by the acquisition of new cytogenetic abnormalities in 50% to 80% of patients.

For the most recent version of the guidelines, please visit NCCN.org

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Jerald P. Radich

accelerated phase and blast crisis vary, the prime factor is blast count, according to Dr. Radich. In most clinical trials, accelerated phase is between 15% and 29% blasts in blood or marrow, with blast crisis being more than 30% blasts in blood and marrow

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Jerald P. Radich

in preventing transformation of disease to accelerated phase/blast crisis, he added. However, in terms of long-term outcomes such as overall and progression-free survivals, Dr. Radich revealed that none of the second-generation agents has proved to

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Susan O’Brien, Jerald P. Radich, Camille N. Abboud, Mojtaba Akhtari, Jessica K. Altman, Ellin Berman, Peter Curtin, Daniel J. DeAngelo, Michael Deininger, Steven Devine, Amir T. Fathi, Jason Gotlib, Madan Jagasia, Patricia Kropf, Joseph O. Moore, Arnel Pallera, Vishnu VB. Reddy, Neil P. Shah, B. Douglas Smith, David S. Snyder, Meir Wetzler, Kristina Gregory and Hema Sundar

expression profiling has shown a close correlation of gene expression between accelerated phase CML (AP-CML) and blast phase CML (BP-CML). The bulk of the genetic changes in progression occur in the transition from CP-CML to AP-CML. 6 The activation of the β

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Susan O'Brien, Camille N. Abboud, Mojtaba Akhtari, Jessica Altman, Ellin Berman, Daniel J. DeAngelo, Steven Devine, Amir T. Fathi, Jason Gotlib, Madan Jagasia, Joseph O. Moore, Javier Pinilla-Ibarz, Jerald P. Radich, Vishnu V.B. Reddy, Neil P. Shah, Paul J. Shami, B. Douglas Smith, David S. Snyder, Meir Wetzler and Furhan Yunus

expression profiling has shown a close correlation of gene expressions between the accelerated and blast phase. Most of the genetic changes in progression occur during the transition from chronic to accelerated phase. 3 Untreated chronic phase CML (CP

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Javier Pinilla-Ibarz and Alfonso Quintás-Cardama

. Nilotinib (formerly AMN107), a highly selective BCR-ABL tyrosine kinase inhibitor, is active in patients with imatinib-resistant or -intolerant accelerated-phase chronic myelogenous leukemia . Blood 2008 ; 111 : 1834 – 1839 . 40 le Coutre PD