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The Role of Early Molecular Response in the Management of Chronic Phase CML

PURPOSE OF REVIEW: Although tyrosine kinase inhibitors (TKIs) spectacularly improve the disease burden and the overall survival of chronic myeloid leukemia patients, early identification of a subset of poor TKI responders has been recognized as a critical goal to prevent disease progression in these...

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Autores principales: Harrington, Patrick, Kizilors, Aytug, de Lavallade, Hugues
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410202/
https://www.ncbi.nlm.nih.gov/pubmed/28405921
http://dx.doi.org/10.1007/s11899-017-0375-0
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author Harrington, Patrick
Kizilors, Aytug
de Lavallade, Hugues
author_facet Harrington, Patrick
Kizilors, Aytug
de Lavallade, Hugues
author_sort Harrington, Patrick
collection PubMed
description PURPOSE OF REVIEW: Although tyrosine kinase inhibitors (TKIs) spectacularly improve the disease burden and the overall survival of chronic myeloid leukemia patients, early identification of a subset of poor TKI responders has been recognized as a critical goal to prevent disease progression in these patients. We herein review the past and recent evidence on the impact of early response. RECENT FINDINGS: In the recent years, the achievement of an early molecular response (EMR, defined as 3-month BCR-ABL1 transcript <10% IS) has emerged as a useful tool to identify poor-risk patients. Although several groups have reported the importance of such milestone, clinical intervention based on it remains controversial partly due to its low specificity to predict progression, which may be partially improved by using the rate of decline in BCR-ABL1 transcript level (halving time or velocity of ratio reduction). SUMMARY: Standardization of halving time or velocity of ratio reduction will likely help establishing more stringent recommendation and modify current clinical practices.
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spelling pubmed-54102022017-05-15 The Role of Early Molecular Response in the Management of Chronic Phase CML Harrington, Patrick Kizilors, Aytug de Lavallade, Hugues Curr Hematol Malig Rep Chronic Myeloid Leukemias (J Pinilla-Ibarz, Section Editor) PURPOSE OF REVIEW: Although tyrosine kinase inhibitors (TKIs) spectacularly improve the disease burden and the overall survival of chronic myeloid leukemia patients, early identification of a subset of poor TKI responders has been recognized as a critical goal to prevent disease progression in these patients. We herein review the past and recent evidence on the impact of early response. RECENT FINDINGS: In the recent years, the achievement of an early molecular response (EMR, defined as 3-month BCR-ABL1 transcript <10% IS) has emerged as a useful tool to identify poor-risk patients. Although several groups have reported the importance of such milestone, clinical intervention based on it remains controversial partly due to its low specificity to predict progression, which may be partially improved by using the rate of decline in BCR-ABL1 transcript level (halving time or velocity of ratio reduction). SUMMARY: Standardization of halving time or velocity of ratio reduction will likely help establishing more stringent recommendation and modify current clinical practices. Springer US 2017-04-12 2017 /pmc/articles/PMC5410202/ /pubmed/28405921 http://dx.doi.org/10.1007/s11899-017-0375-0 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Chronic Myeloid Leukemias (J Pinilla-Ibarz, Section Editor)
Harrington, Patrick
Kizilors, Aytug
de Lavallade, Hugues
The Role of Early Molecular Response in the Management of Chronic Phase CML
title The Role of Early Molecular Response in the Management of Chronic Phase CML
title_full The Role of Early Molecular Response in the Management of Chronic Phase CML
title_fullStr The Role of Early Molecular Response in the Management of Chronic Phase CML
title_full_unstemmed The Role of Early Molecular Response in the Management of Chronic Phase CML
title_short The Role of Early Molecular Response in the Management of Chronic Phase CML
title_sort role of early molecular response in the management of chronic phase cml
topic Chronic Myeloid Leukemias (J Pinilla-Ibarz, Section Editor)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410202/
https://www.ncbi.nlm.nih.gov/pubmed/28405921
http://dx.doi.org/10.1007/s11899-017-0375-0
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