European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia

Leukemia
A HochhausR Hehlmann

Abstract

The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advan...Continue Reading

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Methods Mentioned

BETA
biopsy
PCR
Fluorescence
bone marrow aspirations
bone marrow aspiration

Clinical Trials Mentioned

NCT02602314

Software Mentioned

ENESTchina
SUSTRENIM
ENEST1st
ENESTnd
EUTOS
Euro
Sokal
ENESTcmr

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