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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018
European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia
A Hochhaus1, M Baccarani2, R T Silver3
1Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany. andreas.hochhaus@med.uni-jena.de.
Leukemia
|March 5, 2020
Summary
Chronic myeloid leukemia (CML) treatment has advanced, aiming for deep molecular response and treatment-free remission (TFR). Guidelines were updated to reflect new evidence for achieving these goals in CML management.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Chronic myeloid leukemia (CML) treatment has evolved significantly, improving life expectancy for many patients.
- Current goals include achieving deep molecular response (DMR) and enabling treatment-free remission (TFR).
Purpose of the Study:
- To critically evaluate and update evidence for achieving DMR and TFR in CML.
- To provide updated recommendations for CML management based on recent advancements.
Main Methods:
- Expert panel convened by European LeukemiaNet.
- Review of current evidence regarding CML treatment strategies.
- Assessment of tyrosine kinase inhibitors (TKIs) and monitoring techniques.
Main Results:
- First-line treatment options include various TKIs; generic imatinib is cost-effective.
- EUTOS long-term survival (ELTS)-score aids in assessing patient risk.
- Monitoring response via quantitative polymerase chain reaction is recommended.
- Treatment changes are advised for intolerance or unmet molecular milestones.
- BCR-ABL1 levels >10% at 3 months indicate treatment failure.
- Allogeneic transplantation remains an option for advanced CML.
- TKIs should be withheld during pregnancy.
Conclusions:
- Treatment discontinuation for TFR is feasible in patients with sustained DMR.
- Updated guidelines support optimizing CML therapy towards cure and improved quality of life.
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