Chronic myeloid leukemia: In pursuit of perfection

The resounding success of imatinib (IM) as front line treatment in patients with chronic myeloid leukemia (CML) has certainly made a paradigm shift in the therapeutic algorithm of this disorder. The precise targeting of the BCR-ABL oncogene in CML has entitled it to be the poster child of translational medicine with a well-deserved Oscar ovation from the oncology community. Clinicians are now empowered with first-, second- and third-generation tyrosine kinases, as well as advanced molecular tools to monitor disease and characterize resistance. We have come a long way in successfully managing these patients, but there are still a significant few unmet clinical needs which need addressing and targeting to optimize clinical outcomes. This review focuses on 4 such pertinent and relevant clinical issues, which still need ironing out to fulfill our ambition of achieving ‘perfection’ in this patient cohort.