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Published on: March 5, 2018
Response definitions and European Leukemianet Management recommendations
Michele Baccarani1, Fausto Castagnetti, Gabriele Gugliotta
1Department of Hematology-Oncology L. and A. Seràgnoli, S.Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy. michele.baccarani@unibo.it
Imatinib therapy for chronic myeloid leukaemia (CML) response is assessed by haematologic, cytogenetic, and molecular criteria. Optimal response ensures continued imatinib, while failure necessitates switching to second-generation TKIs or stem cell transplantation.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Imatinib is the standard first-line treatment for chronic myeloid leukaemia (CML).
- Treatment response is evaluated using haematologic (HR), cytogenetic (CgR), and molecular (MolR) assessments.
- Defining optimal, suboptimal, and failure responses is crucial for guiding CML management.
Purpose of the Study:
- To define optimal, suboptimal, and failure response criteria for imatinib therapy in CML.
- To provide treatment recommendations based on response levels.
- To outline provisional response definitions for second-generation TKIs.
Main Methods:
- Evaluation of response based on blood counts (HR), bone marrow metaphases (CgR), and BCR-ABL transcript levels (MolR).
- Defined specific time points and thresholds for optimal response and failure.
- Established criteria for suboptimal response and outlined treatment strategies.
Main Results:
- Optimal response at 3, 6, 12, and 18 months involves specific HR, CgR, and MolR targets.
- Failure is defined by incomplete HR, lack of CgR, or loss of response.
- Suboptimal response encompasses all other scenarios, with varied management options.
Conclusions:
- Continued imatinib for optimal responders is recommended.
- Failure warrants switching to second-generation TKIs or stem cell transplantation.
- Suboptimal responders may continue imatinib or switch to second-generation TKIs.
