What is the first-line treatment for Chronic Myeloid Leukemia (CML)?

Imatinib is the first-line treatment for Chronic Myeloid Leukemia (CML) because it specifically targets the BCR-ABL fusion protein that is the hallmark of this disease. This fusion protein results from a genetic translocation between chromosomes 9 and 22, leading to a continuously active tyrosine kinase that drives the proliferation of myeloid cells. Imatinib is a tyrosine kinase inhibitor that effectively blocks this overactive protein, leading to decreased cell proliferation and increased apoptosis of the leukemic cells.

By focusing on the specific molecular mechanism of CML, imatinib represents a targeted therapy rather than traditional chemotherapy, which often has wider systemic effects and is less specific to the underlying cause of CML. This targeted action results in improved responses, fewer side effects, and better overall survival rates for patients with CML compared to older treatment options.

Other potential treatments like chemotherapy, bone marrow transplant, and radiation therapy may be options in certain scenarios or for other hematological conditions, but they do not have the targeted efficacy of imatinib in the context of CML. Chemotherapy generally applies to more aggressive leukemias or for acute situations, while bone marrow transplant may be considered for patients who are resistant to imatin