Indirubin and Meisoindigo in the Treatment of Chronic Myelogenous Leukemia in China

The aim of this review is to summarize our experience and the current knowledge on the clinical results of Indirubin, a minor active constituent of a well-know traditional Chinese prescription, Ganggui Luhui Wan, and its analogue, Meisoindigo, in the treatment of chronic myelogenous leukemia (CML) in China. Indirubin and meisoindigo induced hematologic remission in patients with chronic phase (CP) CML as effective as hydroxyurea and busulfan, in addition, there were no significant differences in median duration of CP, median survival and blast crisis at 60 months from diagnosis in indirubin, meisoindigo, hydroxyurea and busulfan treated groups. However, when meisoindigo was combined with hydroxyurea, there was evidence of a significantly prolonged median duration of CP, median survival and a reduced incidence of blast crisis at 60 months compared with busulfan, meisoindigo and hydroxyurea alone. The critical mechanisms of indirubin and meisoindigo action have not yet been identified. Both antiproliferative and induced apoptosis mechanisms have been described. Further research, especially randomized trials, are required to confirm the role of indirubin and meisoindigo in the treatment of CML.