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Disorders of Leukocytes01:27

Disorders of Leukocytes

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Common myeloid progenitors (CMPs) are oligopotent cells that can differentiate into granulocytes and macrophages. Granulocytes and macrophages are essential for protecting the body against bacterial, viral, or fungal infections. They migrate from the bone marrow into the circulating blood to reach specific tissue sites where they differentiate and help in immune surveillance. However, they survive only for a few days and must be continuously made available to the organism to maintain a robust...
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Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up
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[Chronic myeloid leukemia].

Noriko Usui

    Nihon Rinsho. Japanese Journal of Clinical Medicine
    |July 15, 2014
    PubMed
    Summary

    Second-generation tyrosine kinase inhibitors (TKIs) offer faster and deeper responses than imatinib for chronic myeloid leukemia (CML). These advanced TKIs, along with bosutinib and ponatinib, provide options for various CML treatment lines and resistance mutations.

    Area of Science:

    • Hematology
    • Oncology
    • Pharmacology

    Background:

    • Imatinib, the first BCR-ABL tyrosine kinase inhibitor (TKI), has been a cornerstone in treating chronic myeloid leukemia (CML) for over a decade.
    • Numerous patients worldwide continue imatinib therapy for CML.
    • The advent of TKIs has revolutionized CML management.

    Purpose of the Study:

    • To review the efficacy and applications of various BCR-ABL TKIs in chronic myeloid leukemia (CML) treatment.
    • To compare first-generation and second-generation TKIs in the context of CML therapy.
    • To highlight TKIs effective against imatinib-resistant CML and specific mutations.

    Main Methods:

    • Review of randomized trials comparing imatinib with second-generation TKIs (dasatinib, nilotinib).

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  • Evaluation of bosutinib for imatinib-resistant/intolerant CML.
  • Assessment of ponatinib's activity against the T315 mutation in CML.

    • Main Results:

    • Second-generation TKIs (dasatinib, nilotinib) demonstrate faster and deeper responses compared to imatinib.
    • These TKIs are suitable as first-line therapy for newly diagnosed chronic phase CML (CP-CML).
    • Bosutinib is effective for imatinib-resistant/intolerant CP-CML, used in second or third-line therapy.
    • Ponatinib is the sole TKI with activity against the T315 mutation, crucial for resistant CML.

    Conclusions:

    • Second-generation TKIs represent significant advancements over imatinib for CML treatment.
    • Bosutinib and ponatinib offer critical therapeutic options for specific CML patient populations, including those with resistance.
    • Treatment decisions among TKIs necessitate careful consideration of individual patient side effect profiles and comorbidities.