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Targeted treatment of hypereosinophilic syndromes and chronic eosinophilic leukemias with imatinib mesylate.

机译:甲磺酸伊马替尼靶向治疗高嗜酸性粒细胞综合征和慢性嗜酸性粒细胞白血病。

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摘要

Idiopathic hypereosinophilic syndrome (HES) and chronic eosinophilia leukemia (CEL) represent the most recent additions to the list of molecularly defined chronic myeloproliferative disorders. Beginning with the observation that imatinib mesylate (Gleevec) could elicit rapid and complete hematologic remissions in a proportion of patients with HES, a reverse bedside-to-bench translational research effort led to the discovery of FIP1L1-PDGFRA, a novel fusion gene on chromosome 4q12 whose product is an imatinib-sensitive protein tyrosine kinase. FIP1L1-PDGFRA is the first description of a gain-of-function fusion gene derived from an interstitial chromosomal deletion rather than a reciprocal translocation. Empiric use of imatinib in HES and CEL provides a dramatic example of how the development of targeted therapeutics can provide tremendous insight into the molecular etiology of what appear to be a diverse and otherwise indecipherable collection of diseases. In this review, we discuss the role of imatinibin HES/CEL and other malignancies characterized by constitutively activated tyrosine kinases, and examine molecular features of the FIP1L1-PDGFRA fusion.
机译:特发性高嗜酸性粒细胞综合征(HES)和慢性嗜酸性粒细胞白血病(CEL)代表了分子定义的慢性骨髓增生性疾病列表中的最新成员。从观察到甲磺酸伊马替尼(Gleevec)可以在一定比例的HES患者中引起快速和完全的血液学缓解开始,逆向床旁台转换研究的努力导致发现了FIP1L1-PDGFRA,它是染色体上的新型融合基因4q12,其产物是对伊马替尼敏感的蛋白酪氨酸激酶。 FIP1L1-PDGFRA是从间质染色体缺失而不是相互易位衍生的功能获得融合基因的第一个描述。伊马替尼在HES和CEL中的经验性使用提供了一个引人注目的示例,说明了靶向治疗剂的开发如何可以提供对似乎是多种多样且无法辨认的疾病集合的分子病因学的深入了解。在这篇综述中,我们讨论了伊马替宁HES / CEL和其他以组成性激活的酪氨酸激酶为特征的恶性肿瘤的作用,并研究了FIP1L1-PDGFRA融合的分子特征。

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