Velcade (Bortezomib - PS341) in the Treatment of Patients Over 18 Years With Ph+ Leukemia
Status:
Completed
Trial end date:
2008-02-01
Target enrollment:
Participant gender:
Summary
Ph+ leukemias (i.e.Chronic Myelogenous Leukemia (CML) and (Ph+) Acute Lymphoblastic Leukemia
are malignant clonal disorder of the hemopoietic stem cell due to reciprocal translocation of
genetic material between chromosome 9 and 22 giving rise to the translocation t(9;22) (q2.2;
q2.1). The translocation causes the formation of a new hybrid gene (bcr-abl) that codes for a
185 kb or 210 kb cytoplasmic protein (P185 and P210 respectively) that by autophosphorylation
activates a number of signaling pathways involved in cell proliferation, maturation,
apoptosis and adhesion, leading to the malignant cell transformation1-3. The course of the
disease goes on through a chronic phase (CP), usually lasting some years, that is
characterized by a massive myeloid hyperplasia with hyperleukocytosis and splenomegaly. The
CP is almost always followed by an accelerated or blastic phase (ABP) where the leukemic
process acquires the characteristics of acute leukemia. The ABP usually lasts some months and
terminates with the death of the patient3.
The frequency of CML in western countries ranges between 10 and 15 per million persons (age -
standardized). It is rare in children. The median age is 55 years.
Current treatment of CML includes conventional chemotherapy, allogeneic bone marrow
transplantation (allo BMT), alpha-interferon (alpha-IFN)and imatinib.