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Wednesday, January 07, 2009

A drug used in the treatment of CML is Imatinib Mesylate Gleevec ST1571

Question 83
A drug used in the treatment of CML is – imatinb CML
a.       Imatinib Mesylate
b.      Gleevee
c.       ST1571
d.      All of the above
d. All of the above
Harrison 16th Edition Page 639
Allogeneic Stem Cell Transplant (SCT) is the only curative therapy for CML and, when feasible, is the treatment of choice. However, it is complicated by a high early mortality rate owing to the transplant procedure.
Outcome of SCT depends on multiple factors including:
(1) the patient (i.e., age and phase of disease);
(2) the type of donor [i.e., syngeneic (monozygotic twins) or HLA-compatible allogeneic, related or unrelated];
(3) the preparative regimen;
(4) GVHD; and
(5) posttransplantation treatment
Ä     Imatinib is a drug used to treat certain types of cancer. It is currently marketed by Novartis as Gleevec (USA) or Glivec (Europe/Australia) as its mesylate salt, imatinib mesilate (INN). It was originally coded during development as CGP57148B or STI-571 (these terms are used in early preclinical publications). It is used in treating chronic myelogenous leukemia (CML), gastrointestinal stromal tumors (GISTs) and a number of other malignancies.
Ä     It is the first member of a new class of agents that act by inhibiting particular tyrosine kinase enzymes, instead of non-specifically inhibiting rapidly dividing cells.
Some students felt that Infliximab was one of the choices
Ä     Infliximab is a “chimeric monoclonal antibody” (“chimeric” refers to the use of both mouse (murine) and human components of the drug i.e. murine binding VK and VH domains and human constant Fc domains)
Ä     The drug blocks the action of TNFα (tumour necrosis factor alpha) by binding to it and preventing it from signaling the receptors for TNFα on the surface of cells. (TNFα is one of the key cytokines that triggers and sustains the inflammation response.)
Ä     Infliximab is used in the treatment of
o       psoriasis,
o       pediatric Crohn's disease,
o       ankylosing spondylitis,
o       psoriatic arthritis,
o       rheumatoid arthritis,
o       ulcerative colitis.
Ä     Infliximab  is administered by intravenous infusion, typically at 6-8 week intervals.

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