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The treatment of accelerated phase and blastic phase chronic myelogenous leukemia (CML) is much more challenging than for the chronic phase of the disease. Currently, allogeneic SCT is the only treatment with know curative potential for accelerated phase and blastic phase chronic myelogenous leukemia, however, the rate of success is variable. The estimated cure rate for patients with accelerated phase chronic myelogenous leukemia ranges from 15% to 40% and is significantly lower (5% to 20%) for patients with blastic phase chronic myelogenous leukemia.

In addition to allogeneic SCT, imatinib mesylate (Gleevec) is the only other approved treatment for the accelerated and blastic phases of the disease. As mentioned previously, imatinib mesylate is much more effective for controlling chronic phase chronic myelogenous leukemia than either the accelerated or blastic phases of the disease. Several encouraging clinical trials have been conducted which demonstrated the efficacy of imatinib mesylate for the treatment of chronic myelogenous leukemia at various phases of the disease. In general, the results of these studies can be summarized as follows:

• Chronic phase chronic myelogenous leukemia - A complete hematologic response was observed in about 95% of patients and a major cytogenetic response was noted in about 60% of patients.

• Accelerated phase chronic myelogenous leukemia - Approximately 70% of patients in the accelerated phase of chronic myelogenous leukemia who were treated with imatinib mesylate achieved a complete hematologic response but only 24% achieved a major cytogenetic response.

• Blastic phase chronic myelogenous leukemia - Treatment of patients in blast crisis with imatinib mesylate resulted in a complete hematologic response in 30% and a major cytogenetic response in 16%.

Due to the high rates of disease recurrence in the accelerated and blastic phases of the disease, patients may wish to discuss with their oncologist the risks and benefits of participating in a clinical trial. Information regarding ongoing clinical studies in your area can be obtained at the Clinical Trials Listing Service at http://www.centerwatch.com