MYELODYSPLASTIC/MYELOPROLIFERATIVE DISEASES (MDS/MPD)—RARE DISEASES OF THE BLOOD AND BONE MARROW

MDS/MPD are clonal myeloid disorders (ie, where the bone marrow includes a population of cells ultimately derived from a single abnormal cell) that have both dysplastic and proliferative features.^1,2

The pathophysiology involves abnormalities in the regulation of myeloid pathways for cellular proliferation, maturation, and survival.¹

There are 3 main MDS/MPD diseases³

Chronic myelomonocytic leukemia (CMML)
Atypical chronic myeloid leukemia (aCML)
Juvenile myelomonocytic leukemia (JMML)

Each of these disorders is very rare but can be life-threatening.^1,2

Clinical presentation and diagnosis

Disease manifestations are due to cytopenias and can include⁴:

Fatigue
Pallor
Exertional dyspnea
Infections
Easy bruising
Bleeding

Diagnostic tests may include blood cell counts using blood and bone marrow. Cytogenetic testing may also be performed.³

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Prescribing GLIVEC

PRESCRIBING GLIVEC FOR MYELODYSPLASTIC/MYELOPROLIFERATIVE DISORDERS

GLIVEC is indicated for the treatment of adult patients with MDS/MPD associated with platelet-derived growth factor receptor (PDGFR) gene rearrangements.^1*

The recommended dose of GLIVEC is 400 mg/day for patients with MDS/MPD.¹

Treatment duration: In the only clinical trial performed to date, treatment with GLIVEC was continued until disease progression. At the time of analysis, the treatment duration was a median of 47 months (24 days - 60 months).¹

Dose adjustments for neutropenia and thrombocytopenia in MDS/MPD¹
MDS/MPD (starting dose 400 mg)	ANC <1.0 x 10⁹/L and/or Platelets <50 x 10⁹/L	Stop GLIVEC until ANC =1.5 x 10⁹/L and platelets =75 x 10⁹/L. Resume treatment with GLIVEC at the original starting dose of 400 mg. If recurrence of ANC <1.0 x 10⁹/L and/or platelets <50 x 10⁹/L, repeat step 1 and resume GLIVEC at a reduced dose of 300 mg.

Myelodysplastic/myeloproliferative diseases with PDGFR gene rearrangements could be associated with high eosinophil levels. Evaluation by a cardiology specialist, performance of an echocardiogram, and determination of serum troponin should therefore be considered in patients with MDS/MPD associated with high eosinophil levels before imatinib is administered. If either is abnormal, follow-up with a cardiology specialist and the prophylactic use of systemic steroids (1-2 mg/kg) for 1 to 2 weeks concomitantly with imatinib should be considered at the initiation of therapy.¹

Response rates seen in patients with MDS/MPD receiving GLIVEC 400 mg/day in clinical trials and published case reports^�

Effect of GLIVEC in MDS/MPD²
	Number of patients	Complete hematologic response	Major cytogenetic response
		n (%)	n (%)
Overall population	31	14 (45%)	12 (39%)
Chromosome 5 translocation	14	11 (79%)	11 (79%)
Chromosome 4 translocation	2	2 (100%)	1 (50%)
Others/no translocation	14	1 (7%)	0 (0%)
Molecular relapse	1	NE	NE

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* In MDS/MPD patients, the efficacy of GLIVEC is based on overall hematologic and cytogenetic response rates. The experience with GLIVEC in patients with MDS/MPD associated with PDGFR gene rearrangements is very limited. There are no controlled trials demonstrating a clinical benefit or increased survival for these diseases.¹

^�Seven patients aged 20 to 86 years with MDS/MPD were studied in an open-label, multicenter, phase 2 clinical trial that was conducted testing GLIVEC in diverse populations of patients with life-threatening diseases involving Abl, KIT, or PDGFR protein tyrosine.

kinases. Median duration of therapy was 12.9 months. A further 24 patients aged 2 to 79 years were reported in 12 published case reports and a clinical study, with a duration of therapy ranging from 1 week to more than 18 months in responding patients. Response durations for patients in the phase 2 study ranged from 141+ to 457+ days.²

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GLIVEC is approved for use in 116 countries around the world.

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MYELODYSPLASTIC/MYELOPROLIFERATIVE DISEASES (MDS/MPD)—RARE DISEASES OF THE BLOOD AND BONE MARROW

There are 3 main MDS/MPD diseases³

Clinical presentation and diagnosis

PRESCRIBING GLIVEC FOR MYELODYSPLASTIC/MYELOPROLIFERATIVE DISORDERS

Response rates seen in patients with MDS/MPD receiving GLIVEC 400 mg/day in clinical trials and published case reports^�

Glivec and KIT+ Gist

Glivec and Ph+ CML

Glivec and Additional Indications

For Your Patients

Library and Tools

Survey Participation Request

Welcome to the GLIVEC Product Website

GLIVEC is approved for use in 116 countries around the world.

GLIVEC Country-Level Websites

GLIVEC International Website

MYELODYSPLASTIC/MYELOPROLIFERATIVE DISEASES (MDS/MPD)—RARE DISEASES OF THE BLOOD AND BONE MARROW

There are 3 main MDS/MPD diseases3

Clinical presentation and diagnosis

PRESCRIBING GLIVEC FOR MYELODYSPLASTIC/MYELOPROLIFERATIVE DISORDERS

Response rates seen in patients with MDS/MPD receiving GLIVEC 400 mg/day in clinical trials and published case reports�

Glivec and KIT+ Gist

Glivec and Ph+ CML

Glivec and Additional Indications

For Your Patients

Library and Tools

There are 3 main MDS/MPD diseases³

Response rates seen in patients with MDS/MPD receiving GLIVEC 400 mg/day in clinical trials and published case reports^�