Chronická myeloidní leukemie v roce 2015
| Title in English | Chronic myeloid leukemia in 2015 |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Onkologie |
| MU Faculty or unit | |
| Citation | |
| Field | Oncology and hematology |
| Keywords | chronic myeloid leukemia; BCR-ABL1; tyrosine kinase inhibitors; allogeneic stem cells transplantation |
| Description | Natural course and particularly prognosis of the patients with chronic myeloid leukemia (CML) improved fundamentally during last fourteen years thanks to tyrosine kinase inhibitors (TKI) targeted therapy introduction. Currently, three TKI (imatinib, nilotinib, and dasatinib) are available for the first line treatment, and two other efficient drugs (bosutinib and ponatinib) can be used in the case of failure or intolerance of previously administered TKI. Regular and standardized treatment efficacy monitoring is crucial for appropriate and timely change of therapy when required responses are not met in given time points. Prognostic significance of early treatment switch in case of failure to achieve an early molecular response has not been established yet. Similarly, even if the data suggest possibility and feasibility of stopping TKI therapy in patients with durable deep molecular response, at present, stopping TKI should only be done in the context of clinical trials and cannot be routinely recommended into clinical practice. Allogeneic stem cells transplantation is still the only curative treatment option even in the TKI era, and should be used in the following situations: patients who fail at least 2 TKI, patients with presence of T315I mutation and patients who progress into advanced stages of the disease. |