ABSTRACT
Imatinib has been recognized as a major treatment for patients with chronic myelogenous leukemia (CML). Strategies to overcome imatinib resistance that might occur at the standard of 400 mg/day include imatinib-based combination therapies and high dose imatinib. High dose imatinib can be considered as a reasonable option, since most of these studies have shown no maximum tolerated dose and no increase in non-hematological toxicity at doses up to 1000 mg/day. In order to obtain a higher rate of cytogenetic response and to overcome resistances, new strategies using combination of cytotoxic drugs with imatinib have emerged. Although resistance to imatinib develops most frequently in patients in advanced phase, this event may occur in chronic phase patients. Preliminary results obtained with high dose imatinib as well as with combination therapies are promising. High dose of imatinib may also be used in order to recapture responses in patients who fail or have suboptimal response to standard dose imatinib.
