• Hematology Disease Site Group. Walker I, Makarski J, Stevens A, Meyer RM. Treatment of chronic myeloid leukemia with imatinib. Toronto (ON): Cancer Care Ontario (CCO); 2004 Jul 16. 27 p. (Practice guideline report; no. 6-15). [39 references]

• Imatinib is recommended as first-line therapy in newly diagnosed patients with Philadelphia chromosome-positive chronic myeloid leukemia. The initial recommended dose of therapy is 400 milligrams (mg), given orally, once daily. For patients who do not demonstrate a complete hematologic response after three months of therapy or at least a minor cytogenetic response after 12 months of therapy, the dose of imatinib should be increased to 400 mg, given orally, twice daily.
• Imatinib is recommended for patients who have become refractory to or intolerant of previous therapy (e.g., interferon +/- cytarabine, hydroxyurea) or who have disease progression to accelerated or myeloid blastic phases of the disease. For patients with accelerated or myeloid blastic phases of the disease, the starting dose of imatinib should be 600 mg, given orally, once daily with an increase in dose to 400 mg, given orally, twice daily, if an adequate hematologic or cytogenetic response is not observed.

None provided

The recommendations are supported by non-randomized trials, a randomized controlled trial and a systematic review.

• Hematology Disease Site Group. Walker I, Makarski J, Stevens A, Meyer RM. Treatment of chronic myeloid leukemia with imatinib. Toronto (ON): Cancer Care Ontario (CCO); 2004 Jul 16. 27 p. (Practice guideline report; no. 6-15). [39 references]

Not applicable: The guideline was not adapted from another source.

2004 Jul 16

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Program in Evidence-based Care (PEBC) is a project supported by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

Provincial Hematology Disease Site Group

Members of the Hematology Disease Site Group disclosed potential conflict of interest information.

None available

This summary was completed by ECRI on September 9, 2005. The information was verified by the guideline developer on October 3, 2005. This summary was updated by ECRI on November 13, 2006 following the FDA advisory on Gleevec (imatinib mesylate).