European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013.

Blood 2013 Aug 26;122(6):872-84. Epub 2013 Jun 26.

Department of Hematology L. and A. Seràgnoli, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna, Italy.

Advances in chronic myeloid leukemia treatment, particularly regarding tyrosine kinase inhibitors, mandate regular updating of concepts and management. A European LeukemiaNet expert panel reviewed prior and new studies to update recommendations made in 2009. We recommend as initial treatment imatinib, nilotinib, or dasatinib. Response is assessed with standardized real quantitative polymerase chain reaction and/or cytogenetics at 3, 6, and 12 months. BCR-ABL1 transcript levels ≤10% at 3 months, <1% at 6 months, and ≤0.1% from 12 months onward define optimal response, whereas >10% at 6 months and >1% from 12 months onward define failure, mandating a change in treatment. Similarly, partial cytogenetic response (PCyR) at 3 months and complete cytogenetic response (CCyR) from 6 months onward define optimal response, whereas no CyR (Philadelphia chromosome-positive [Ph+] >95%) at 3 months, less than PCyR at 6 months, and less than CCyR from 12 months onward define failure. Between optimal and failure, there is an intermediate warning zone requiring more frequent monitoring. Similar definitions are provided for response to second-line therapy. Specific recommendations are made for patients in the accelerated and blastic phases, and for allogeneic stem cell transplantation. Optimal responders should continue therapy indefinitely, with careful surveillance, or they can be enrolled in controlled studies of treatment discontinuation once a deeper molecular response is achieved.

Download full-text PDF

Source
http://www.leukemia-net.org/content/leukemias/cml/recommenda
Web Search
http://www.bloodjournal.org/content/122/6/872.full.pdf
Web Search
http://www.hematology.fi/sites/default/files/uploads/baccara
Web Search
http://www.bloodjournal.org/cgi/doi/10.1182/blood-2013-05-50
Publisher Site
http://dx.doi.org/10.1182/blood-2013-05-501569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915804PMC
August 2013
80 Reads

Publication Analysis

Top Keywords

months onward
12
onward define
12
months
9
myeloid leukemia
8
cytogenetic response
8
ccyr months
8
pcyr months
8
chronic myeloid
8
define failure
8
european leukemianet
8
response
6
response cyr
4
cyr philadelphia
4
optimal response
4
philadelphia chromosome-positive
4
complete cytogenetic
4
response ccyr
4
define optimal
4
chromosome-positive [ph+]
4
failure optimal
4

References

(Supplied by CrossRef)
Chronic myelogenous leukemia BCR-ABL1 positive.
Vardiman et al.
2008

Similar Publications