When retired four-time Olympic skier AJ Kitt finally told his triplet children he had chronic myeloid leukemia (CML), he expected a moment of gravity, perhaps even tears. Instead, the children—then in their late junior high years—responded with a casualness that stunned him.
“They were just like, ‘OK, can you pass the ketchup?’” Kitt recalls. “It was just no large deal.”
For most people, a cancer diagnosis is a seismic event. But for Kitt and thousands of others, the terror associated with CML has been replaced by a routine. This shift is the legacy of Gleevec (imatinib), a drug that celebrates its 25th anniversary of FDA approval this May. Approved on May 10, 2001, Gleevec did more than treat a specific leukemia; it fundamentally rewrote the playbook for oncology, transforming a once-certain death sentence into a manageable chronic condition.
According to the nonprofit Blood Cancer United, Gleevec has saved an estimated 350,000 lives globally. More importantly, it served as the proof-of-concept for “targeted therapy,” or precision medicine—the idea that drugs could be engineered to attack specific molecular drivers of cancer while leaving healthy cells untouched.
The End of the ‘Death Sentence’ Era
To understand the impact of Gleevec, one must understand the “pre-Gleevec world,” as described by Brian Druker, M.D., CEO of the OHSU Knight Cancer Institute. Before the drug’s arrival, CML was a devastating diagnosis with few effective options. Patients often faced a grueling trajectory toward bone marrow transplants or systemic chemotherapy that offered limited hope.
“People were headed for disaster, and there was nothing I could do about it,” Dr. Druker says. He remembers the visceral heaviness of walking into a clinic to deliver blood counts to patients, knowing the results often signaled the end. “I would come in, and I’d have to say, ‘It’s time to get your affairs in order.’ That’s what it was like.”
The breakthrough came when research identified the specific genetic abnormality driving CML: the Philadelphia chromosome, which creates a fusion protein (BCR-ABL) that tells white blood cells to divide uncontrollably. Gleevec was designed to plug into that specific protein like a key in a lock, shutting down the signal for the cancer to grow. When the drug entered clinical trials, the results were nearly miraculous, with patients seeing their white blood cell counts plummet and their health return in ways previously unseen in leukemia treatment.
From a Routine Physical to a Life-Saving Discovery
For AJ Kitt, the discovery of his CML was a fluke of timing. At 46, the former alpine skier—the first American male to compete in four Olympic games—was the picture of health. He spent his retirement coaching youth ski teams and raising triplets in Oregon, and Colorado. He wasn’t a man prone to regular doctor visits.
The diagnosis began with a recurring winter sinus infection. When a longtime physician friend retired and could no longer call in antibiotics, Kitt visited a new family practitioner. During a routine physical, the doctor felt something unusual: an enlarged spleen. A subsequent ultrasound and blood work confirmed the worst. By Friday afternoon, Kitt was told he had leukemia.
The shock was immediate. Because of his enlarged spleen, Kitt was warned that skiing—his lifelong passion—could be fatal if he crashed, as internal bleeding would be uncontrollable. “I just felt like I was out on an island,” he says. “I was totally flailing.”
A connection through the skiing community led Kitt to Dr. Druker. The first conversation changed everything. Despite being at a conference in Houston, Druker reviewed Kitt’s labs and gave him a definitive promise: “You’re going to be fine. We’re going to take care of you.”
The Architecture of Precision Medicine
Kitt’s journey highlights both the power and the complexity of targeted therapy. He began on Gleevec, which initially brought his leukemia under control. However, after about 18 months, his body developed a resistance to the drug—a known challenge in oncology where cancer cells mutate to bypass the “lock” the drug is trying to plug.
Because Gleevec had paved the way for second-generation inhibitors, Dr. Druker was able to transition Kitt to Sprycel (dasatinib). This switch pushed Kitt into “deep molecular response,” a state of deep remission where the leukemia is nearly undetectable. Today, Kitt is not just surviving; he is thriving, traveling the world with his son Aksel, a competitive skier, and supporting his daughters’ achievements in collegiate athletics and aerospace engineering.
The success of imatinib extended far beyond CML. It demonstrated that molecular targeting could work across different types of malignancies. Today, the drug is used to treat gastrointestinal stromal tumors (GIST) and certain skin cancers, and it has found applications in transplant care and the treatment of autoimmune diseases and fibrosis.
| Era | Primary Treatment Approach | Typical Patient Outcome |
|---|---|---|
| Pre-2001 | Chemotherapy / Bone Marrow Transplant | Poor long-term prognosis; high mortality |
| 2001–2010s | First-Gen Targeted Therapy (Gleevec) | High remission rates; manageable chronic disease |
| Current | Multi-generation TKIs / TFR Potential | Deep molecular response; potential for drug-free survival |
The Next Frontier: Treatment-Free Remission
The ultimate goal for many CML patients is no longer just remission, but Treatment-Free Remission (TFR). For a subset of patients who achieve a deep enough molecular response and maintain it over several years, We see possible to stop medication entirely without the disease returning.
AJ Kitt is currently a candidate for this transition. While the prospect of stopping medication is exhilarating, the safety net is the precision medicine itself: if the CML returns, he can simply resume medication to bring the leukemia back into remission.
Reflecting on the last decade, Kitt views his survival through a lens of profound gratitude. Had he been diagnosed in 1995 instead of 2005, the “pass the ketchup” normalcy of his children’s reaction would have been impossible. Instead, he views Dr. Druker not just as a world-class researcher, but as a clinician who maintains the human touch. “The fact that he discovered and developed Gleevec… And then he sits by your bed and holds your hand; he’s just remarkable,” Kitt says.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
The medical community will continue to mark this milestone with a public celebration titled “Blood Cancer Then & Now: 25 Years of Innovation” on Tuesday, May 19, from 6 to 8 p.m. At the Knight Cancer Research Building in Portland, Oregon, featuring AJ Kitt and Dr. Brian Druker.
Do you or a loved one have a story about how precision medicine changed your life? Share your experience in the comments below or share this article to spread awareness about CML treatment.
