Value of Using Pioglitazone in Chronic Myeloid Leukemia Treatment

Potential Utility of Peroxisome Proliferator-activated Receptor Gamma Agonists in the Eradication of Chronic Myeloid Leukemia Stem Cells: Myth or Truth?

Assessment of patients response and expression levels of CITED2 and HIF2a genes on adding pioglitazone to imatinib therapy.

Eligible denovo CML patients will be treated by combination drug therapy of imatinib 400 mg plus pioglitazone (15 - 30mg).They will be on follow up for their complete blood count (CBC), chemistry profile and random blood sugar every 2 weeks. After 3, 6 and 12 months of treatment the patients response will be evaluated and compared with the obtained responses of a historical control group. Assessment of the hypoxia induced factor 2 alpha (HIF2a) gene and CBP/p300-interacting transactivator with glutamic acid (E) and aspartic acid (D)-rich tail 2 (CITED2) gene expression levels before and after 6 months of treatment will be additionally evaluated.

Inclusion Criteria:

• CML cases (BCR-ABL1 positive)

Exclusion Criteria:

• Accelerated or blastic crisis
• Atypical CML (BCR-ABL1 negative)
• Chronic myelomonocytic leukemia (CMML)
• Pregnant or breastfeeding females.
• Patients with severe organ dysfunction