GENE TECHNOLOGY INVOLVED IN THE TREATMENT GENE TECHNOLOGY INVOLVED IN THE TREATMENT OF CHRONIC MYELOID LEUKEMIA

GENE TECHNOLOGY INVOLVED IN THE TREATMENT OF CHRONIC MYELOID LEUKEMIA

Molecular biology and Pathogenesis:

Chronic Myeloid Leukemia is classically associated with the occurrence of Philadelphia (Ph) chromosome1.  First recounted by Nowell and Hungerford in 1960, it outcomes from reciprocal translocation of genetic material (containing proto-oncogene c-abl) from chromosome 9 to chromosome 22 (at the breakpoint of the bcr locus). It is the hallmark of CML and is found in 95% of patients. It is also discovered in 5% of young kids and 25% of mature persons with acute lymphatic leukemia  and in 20% of patients with acute myeloid leukemia. (Sinclair et al. 2007 Pp. 38)

Evolution of Treatment:

Fowler's answer (arsenicals) was the first remedy utilised for this condition in 1856.  Later radiotherapy was discovered to be useful in commanding the symptoms and signals of CML and it stayed the main stay of remedy until the 1950's (Kinsey S, 2002)In 1953 busulfan replaced radiotherapy.  Hydroxyurea was presented in CML therapy in 1972 and because of its better toxicity profile, it became the preferred agency for the remedy of CML. 

Conventional Chemotherapy:

Busulfan and hydroxyurea controls the signals and symptoms of CML but they do not have any effect on the progression of the disease.  Busulfan controls cell count by portraying on the arise cells.  So it takes about 3 weeks for the enumerate begins falling.  edge effects are also many.  It is best to avoid in patients who are being arranged for skeletal part marrow transplantation (BMT) as the incidence of veno-occlusive infection is high.  Hydroxyurea is helpful in conveying down the counts rapidly as it actions on the proliferating cells and is generally well tolerated.  Hydroxyurea is favoured to busulfan because the median length of  the chronic stage and median survival are considerably better. (Miller et. al. 1998 Pp. 173)

Interferon (IFN):

IFN  a2 a and a 2b, both are utilised in the remedy of CML. Although going throgh the process of neutralisation of antibodies can be detected in the blood of patient's treatment with IFN a 2a, for practical purposes both should be considered equal.  IFN a has only modest activity in late chronic phase (defined as CML diagnosed for more than one year) of CML in patients. Data on the efficacy of interferon is drawn from from the foremost randomized controlled clinical trials.

Therapy initiation

Initiallythe tumor burden ...