A Pill to Control Leukemia

The medical editor for London's Daily Telegraph, Celia Hall, reports on a development that could have an incredible impact on an insidious disease ...

A drug prescribed for one of the commonest forms of leukaemia has reduced the deadly cancer to a chronic illness that can be managed with a single pill a day, specialists said yesterday.

New data issued in London showed that about 90 per cent of patients with chronic myeloid leukaemia (CML) who take the drug Glivec are alive and well after five years.

Before the drug was developed, the blood cancer would become advanced within four to six years, giving little hope of survival.

Specialists described the results as "breathtaking". They said that, unlike some cancer drugs which had shown early promise that then faded, Glivec patients had an "impressively durable resp-onse to the drug."

CML is one of the four most common types of leukaemia. It is a blood cancer in which the white blood cells do not mature and are over-produced.

The condition can lead to tumours forming on the bone marrow or lymph nodes and can also increase the risk of strokes and life-threatening infections.

Patients take the drug for life. In some it is weeks before real benefits can be measured but other patients report feeling better within a few days.

While the drug does not cure the leukaemia, it keeps it under control.

Before Glivec, patients with CML had a life expectancy of four to six years. In the long-term trial only 4.6 per cent of patients died.

The drug costs the health service from £14,000 a year per patient, depending on the strength of the dose, and is recommended for those for whom a bone marrow transplant is not an option.

Pennie Douglas, of CML Support, said her organisation was worried that not all patients had swift access to the drug or that they remained on it.

"We are concerned about people who are not treated at the specialist centres. There are misunderstandings at some hospital departments.

"We have heard that some patients whose test results are good are taken off it. It is a funding issues for many primary care trusts."

About 3,000 people in the country have CML and about 600 a year are newly diagnosed. It usually strikes in middle age.

Glivec is also having good results with a rare cancer of the digestive tract known as gist and is being tried with other cancers, including some that attack the prostate, lungs and brain.

Glivec is designed to stop the cancer cells from multiplying. It works by blocking or inhibiting signals that instruct the cancers cells to divide and grow.

Sufferers normally take one tablet a day for as long as it is shown that they continue to benefit from it.

Users of the drug have reported some mild side-effects, including nausea and sometimes diarrhoea.

It can also cause leg aches and cramp, rashes and swelling of the face, especially around the eyes. Such side-effects are usually treatable.

Charles Craddock, professor of haematology at Birmingham University and the director of the stem cell transplant unit at the city's Queen Elizabeth Hospital, said that results from earlier drug treatments for CML had been "pretty gloomy."

"I am delighted that the remarkable results we initially saw in CML patients treated with Glivec five years ago have continued to improve.

"The significant success of Glivec in treating CML is an exciting model for the development of new treatments for other cancers."

The patient group Gist Support UK welcomed the news.

Dave Cook, a spokesman, said: "The data that we have seen confirm what I have experienced for myself. When six separate gists were removed, I was devastated but after four years on Glivec my scans show no signs of any abnormality. Glivec is a life-saver."

Sandy Craine, 58, from Liverpool, was one of the first people in Britain to take Glivec and formed a support group.

She said: "When it became available five years ago I never believed that I would be standing here today.

"I was told that without invasive chemotherapy following a stem cell transplant I had approximately 12 months to live.

"It has helped save to my life and I am so grateful that I can pass on this message of hope to others diagnosed with this once devastating disease."