The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.
- MeSH
- analýza přežití MeSH
- aniliny terapeutické užití MeSH
- antitumorózní látky terapeutické užití MeSH
- bcr-abl fúzové proteiny antagonisté a inhibitory genetika metabolismus MeSH
- chinoliny terapeutické užití MeSH
- chronická myeloidní leukemie diagnóza farmakoterapie genetika mortalita MeSH
- dasatinib terapeutické užití MeSH
- exprese genu MeSH
- imatinib mesylát terapeutické užití MeSH
- inhibitory proteinkinas terapeutické užití MeSH
- klinické rozhodování MeSH
- konsensuální konference jako téma MeSH
- kvalita života MeSH
- lidé MeSH
- management nemoci MeSH
- monitorování fyziologických funkcí MeSH
- naděje dožití trendy MeSH
- nitrily terapeutické užití MeSH
- pyrimidiny terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- aniliny MeSH
- antitumorózní látky MeSH
- bcr-abl fúzové proteiny MeSH
- BCR-ABL1 fusion protein, human MeSH Prohlížeč
- bosutinib MeSH Prohlížeč
- chinoliny MeSH
- dasatinib MeSH
- imatinib mesylát MeSH
- inhibitory proteinkinas MeSH
- nilotinib MeSH Prohlížeč
- nitrily MeSH
- pyrimidiny MeSH
