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Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia

Important advances in the understanding of the molecular basis of chronic myeloid leukemia have resulted in the development of new therapies and changed the paradigm for managing this myeloproliferative disease. Translocation of chromosomes 9 and 22 (known as the Philadelphia chromosome) results in...

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Autores principales: Bauer, Stephanie, Romvari, Edie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Harborside Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093320/
https://www.ncbi.nlm.nih.gov/pubmed/25031941
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author Bauer, Stephanie
Romvari, Edie
author_facet Bauer, Stephanie
Romvari, Edie
author_sort Bauer, Stephanie
collection PubMed
description Important advances in the understanding of the molecular basis of chronic myeloid leukemia have resulted in the development of new therapies and changed the paradigm for managing this myeloproliferative disease. Translocation of chromosomes 9 and 22 (known as the Philadelphia chromosome) results in a fusion BCR-ABL gene that produces a dysregulated BCR-ABL tyrosine kinase protein and triggers events leading to malignant transformation. The tyrosine kinase inhibitors imatinib, nilotinib, and dasatinib block the BCR-ABL protein and prevent activation of the transformation pathways. Molecular monitoring, the most sensitive approach currently available to assess treatment response, measures BCR-ABL messenger RNA levels and serves as a surrogate marker of disease. Further, molecular responses are predictive of patient outcomes. It is important for advanced practitioners to become familiar with the technology and interpretation of molecular monitoring results as well as efforts to standardize this type of testing so they can educate their patients and aid their understanding of test results. Undetectable BCR-ABL levels can bring feelings of relief, whereas an increasing level can lead to anxiety. Advanced practitioners, therefore, are an important resource for interpreting results for patients, answering questions, alleviating concerns, and encouraging continued adherence to treatment.
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spelling pubmed-40933202014-07-16 Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia Bauer, Stephanie Romvari, Edie J Adv Pract Oncol Review Article Important advances in the understanding of the molecular basis of chronic myeloid leukemia have resulted in the development of new therapies and changed the paradigm for managing this myeloproliferative disease. Translocation of chromosomes 9 and 22 (known as the Philadelphia chromosome) results in a fusion BCR-ABL gene that produces a dysregulated BCR-ABL tyrosine kinase protein and triggers events leading to malignant transformation. The tyrosine kinase inhibitors imatinib, nilotinib, and dasatinib block the BCR-ABL protein and prevent activation of the transformation pathways. Molecular monitoring, the most sensitive approach currently available to assess treatment response, measures BCR-ABL messenger RNA levels and serves as a surrogate marker of disease. Further, molecular responses are predictive of patient outcomes. It is important for advanced practitioners to become familiar with the technology and interpretation of molecular monitoring results as well as efforts to standardize this type of testing so they can educate their patients and aid their understanding of test results. Undetectable BCR-ABL levels can bring feelings of relief, whereas an increasing level can lead to anxiety. Advanced practitioners, therefore, are an important resource for interpreting results for patients, answering questions, alleviating concerns, and encouraging continued adherence to treatment. Harborside Press 2012 2012-05-01 /pmc/articles/PMC4093320/ /pubmed/25031941 Text en Copyright © 2012, Harborside Press http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited and is for non-commercial purposes.
spellingShingle Review Article
Bauer, Stephanie
Romvari, Edie
Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia
title Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia
title_full Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia
title_fullStr Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia
title_full_unstemmed Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia
title_short Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia
title_sort interpreting molecular monitoring results and international standardization in chronic myeloid leukemia
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093320/
https://www.ncbi.nlm.nih.gov/pubmed/25031941
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