Response to imatinib (Gleevec) in accelerated phase and blast phase chronic myeloid leukemia (CML) is inferior to chronic phase, and relapse is frequent. This is associated with Bcr-Abl point mutations, which interfere with imatinib binding. A new drug, dasatinib, overcomes resistance to Gleevec-treated CML patients with advanced disease as well as those with Philadelphia-chromosome positive acute lymphoblastic leukemia (ALL).
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