Final answer:
The treatment of choice for CML with the t(9;22) translocation is targeted therapy with tyrosine kinase inhibitors (TKIs), with imatinib being the most effective. This targeted approach marks a significant shift from traditional combination chemotherapy and has greatly improved the prognosis for many patients with CML.
Step-by-step explanation:
The treatment of choice for Chronic Myelogenous Leukemia (CML) with the t(9;22) translocation, known as the Philadelphia chromosome, is targeted therapy with tyrosine kinase inhibitors (TKIs). One of the most effective TKIs for this purpose is imatinib (Gleevec). Unlike the historical use of combination chemotherapy, which includes a variety of drugs such as methotrexate and vincristine to treat acute lymphoblastic leukemia (ALL), CML with the Philadelphia chromosome is more specifically targeted by TKIs.
Imatinib specifically inhibits the BCR-ABL fusion protein that results from the t(9;22) translocation and is responsible for the uncontrolled proliferation of white blood cells in CML. The advent of TKIs has significantly improved the management of CML, turning what was once a fatal disease into a manageable chronic condition for many patients. This approach emulates the success story of Lance Armstrong, who was cured using cisplatin for metastasized testicular cancer. In the case of CML, it's the targeted inhibition of the aberrant tyrosine kinase that offers the therapeutic benefit.