[Chronic myeloid leukemia. Diagnostics, therapy and future strategy].

Area of Science:

• Hematology
• Oncology
• Pharmacology

Background:

• Chronic myeloid leukemia (CML) survival has significantly improved with imatinib therapy.
• Most patients achieve remission, but a minority develop imatinib resistance or suboptimal response, facing a poor prognosis.

Purpose of the Study:

• To review diagnostic procedures for initial CML diagnosis and treatment response assessment.
• To present European LeukemiaNet guidelines for surveillance and criteria for imatinib resistance/suboptimal response.
• To discuss therapeutic alternatives for imatinib failure, including stem cell transplantation and second-generation inhibitors.

Main Methods:

• Review of diagnostic strategies for CML.
• Analysis of European LeukemiaNet guidelines for monitoring and resistance assessment.
• Discussion of treatment options based on disease stage and response.

Main Results:

• Established guidelines exist for CML diagnosis and monitoring response to imatinib.
• Clear criteria define imatinib resistance and suboptimal response.
• Allogeneic stem cell transplantation and second-generation tyrosine kinase inhibitors are viable alternatives for treatment failure.

Conclusions:

• Accurate diagnostics and adherence to monitoring guidelines are crucial for CML management.
• Timely identification of imatinib resistance or suboptimal response guides therapeutic decisions.
• Personalized treatment strategies, including novel therapies, improve outcomes for CML patients facing treatment failure.