Informace o publikaci

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

Autoři	BACCARANI Michele DEININGER Michael W. ROSTI Gianantonio HOCHHAUS Andreas SOVERINI Simona APPERLEY Jane F. CERVANTES Francisco CLARK Richard E. CORTES Jorge E. GUILHOT Francois HJORTH-HANSEN Henrik HUGHES Timothy P. KANTARJIAN Hagop M. KIM Dong-Wook LARSON Richard A. LIPTON Jeffrey H. MAHON Francois-Xavier MARTINELLI Giovanni MAYER Jiří MUELLER Martin C. NIEDERWIESER Dietger PANE Fabrizio RADICH Jerald P ROUSSELOT Philippe SAGLIO Giuseppe SAUSSELE Susanne SCHIFFER Charles SILVER Richard SIMONSSON Bengt STEEGMANN Juan-Luis GOLDMAN John M HEHLMANN Ruediger
Rok publikování	2013
Druh	Článek v odborném periodiku
Časopis / Zdroj	Blood
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
Doi	http://dx.doi.org/10.1182/blood-2013-05-501569
Obor	Onkologie a hematologie
Klíčová slova	TYROSINE KINASE INHIBITORS; DIAGNOSED CHRONIC-PHASE; CHRONIC MYELOGENOUS LEUKEMIA; PATIENTS RECEIVING IMATINIB; MAJOR CYTOGENETIC RESPONSE; SUBCUTANEOUS OMACETAXINE MEPESUCCINATE; COMPLETE MOLECULAR REMISSION
Popis	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 [Ph1]>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.