TY - JOUR
T1 - Treatment of chronic myeloid leukemia
T2 - assessing risk, monitoring response, and optimizing outcome
AU - Shanmuganathan, Naranie
AU - Hiwase, Devendra Keshaorao
AU - Ross, David Morrall
PY - 2017
Y1 - 2017
N2 - Over the past two decades, tyrosine kinase inhibitors have become the foundation of chronic myeloid leukemia (CML) treatment. The choice between imatinib and newer tyrosine kinase inhibitors (TKIs) needs to be balanced against the known toxicity and efficacy data for each drug, the therapeutic goal being to maximize molecular response assessed by BCR-ABL RQ-PCR assay. There is accumulating evidence that the early achievement of molecular targets is a strong predictor of superior long-term outcomes. Early response assessment provides the opportunity to intervene early with the aim of ensuring an optimal response. Failure to achieve milestones or loss of response can have diverse causes. We describe how clinical and laboratory monitoring can be used to ensure that each patient is achieving an optimal response and, in patients who do not reach optimal response milestones, how the monitoring results can be used to detect resistance and understand its origins.
AB - Over the past two decades, tyrosine kinase inhibitors have become the foundation of chronic myeloid leukemia (CML) treatment. The choice between imatinib and newer tyrosine kinase inhibitors (TKIs) needs to be balanced against the known toxicity and efficacy data for each drug, the therapeutic goal being to maximize molecular response assessed by BCR-ABL RQ-PCR assay. There is accumulating evidence that the early achievement of molecular targets is a strong predictor of superior long-term outcomes. Early response assessment provides the opportunity to intervene early with the aim of ensuring an optimal response. Failure to achieve milestones or loss of response can have diverse causes. We describe how clinical and laboratory monitoring can be used to ensure that each patient is achieving an optimal response and, in patients who do not reach optimal response milestones, how the monitoring results can be used to detect resistance and understand its origins.
KW - BCR-ABL
KW - Chronic myeloid leukemia
KW - minimal residual disease
KW - resistance
UR - http://www.scopus.com/inward/record.url?scp=85019100969&partnerID=8YFLogxK
U2 - 10.1080/10428194.2017.1312377
DO - 10.1080/10428194.2017.1312377
M3 - Review article
C2 - 28482729
AN - SCOPUS:85019100969
SN - 1042-8194
VL - 58
SP - 2799
EP - 2810
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 12
ER -