Sargramostim (GM-CSF, Leukine, Prokine) is a human recombinant granulocyte and macrophage colony-stimulating factor that stimulates the production and potentiates the function of both granulocytes and macrophages from hematopoietic progenitor cells. It is used to accelerate bone marrow repopulation after high-dose chemotherapy, radiation therapy, and bone marrow transplantation. Adverse effects associated with sargramostim use include bone pain (similar to that of filgrastim), fatigue, fevers, skin rash, malaise, and fluid retention.


Imantinib mesylate (Gleevec) is a rationally designed inhibitor of the tumor-specific bcr-abl kinase. The Philadelphia chromosome, present in nearly all patients with chronic myelogenous leukemia (CML), is produced by a chromosomal rearrangement linking the bcr and the abl genes. The bcr-able kinase is therefore a unique drug target in leukemic cells, and imantinib selectively and potently inhibits this kinase. Remissions in CML patients are achieved with high frequency and very low toxicity, and this compound may become a front-line agent for treating this cancer. Unfortunately, drug resistance has already been observed in the clinic as a result of mutations in the bcr-abl kinase, and this magic bullet does not appear to be curative for CML patients. Extension of the use of imantinib to other tumor types with overexpression of c-kit kinase or platelet-derived growth factor kinase is undergoing development because of its observed activity against these kinases.

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