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An analysis of strategic treatment interruptions during imatinib treatment of chronic myelogenous leukemia with imatinib-resistant mutations

机译：伊马替尼抗性白血病伊马替尼治疗慢性髓性白血病的战略治疗中断分析

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Chronic myelogenous leukemia (CML) is a cancer of the white blood cells that results from increased and uncontrolled growth of myeloid cells in the bone marrow and the accumulation of these cells in the blood. The most common form of treatment for CML is imatinib, a tyrosine kinase inhibitor. Although imatinib is an effective treatment for CML and most patients treated with imatinib do attain some form of remission, imatinib does not completely eradicate all leukemia cells, and if treatment is stopped, all patients eventually relapse (Cortes, 2005). In Kim (2008), the authors developed a mathematical model for the dynamics of CML under imatinib treatment that incorporates the anti-leukemia immune response, and in Paquin (2011), the authors used this mathematical model to study strategic treatment interruptions as a potential therapeutic strategy for CML patients. Although the authors presented the results of several numerical simulations in Paquin (2011), the studies in that work did not include the possibility of imatinib-resistant mutations or an initial population of imatinib-resistant leukemia cells. As resistance is a significant consideration in any drug treatment, it is important to study the efficacy of the strategic treatment interruption plan in the presence of imatinib resistance. In this work, we modify the delay differential equations model of Kim (2008), Paquin (2011) to include the possibility of imatinib resistance, and we analyze strategic treatment interruptions as a potential therapeutic tool in the case of patients with imatinib-resistance leukemia cells.
机译：慢性髓性白血病（CML）是白细胞的癌症，导致骨髓中骨髓细胞的增加和不受控制的生长和这些细胞在血液中的积累。 CML的最常见的治疗方式是伊马替尼，酪氨酸激酶抑制剂。尽管伊马替尼对CML进行了有效的治疗，但大多数用伊马替尼治疗的患者达到某种形式的缓解，伊马替尼并未完全消除所有白血病细胞，并且如果停止治疗，所有患者最终复发（Cortes，2005）。在Kim（2008）中，作者开发了CML的动态的数学模型，即在伊马替尼治疗下掺入抗白血病免疫反应，并在Paquin（2011年）中，使用该数学模型来研究战略治疗中断作为潜力CML患者的治疗策略。虽然作者呈现了Paquin（2011）中若干数值模拟的结果，但该工作的研究不包括伊马替尼抗性突变或初始植物抗性白血病细胞的初始群体的可能性。由于抗性是任何药物治疗的重大考虑，重要的是研究战略治疗中断计划在伊马替尼抗性存在下的功效。在这项工作中，我们修改了金（2008），Paquin（2011）的延迟微分方程模型，包括伊马替尼阻力的可能性，并且在伊替尼抗性白血病患者的情况下，将战略治疗中断作为潜在的治疗工具分析细胞。

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