Monitoring minimal residual disease in patients with chronic myeloid leukemia after treatment with tyrosine kinase inhibitors

Current Opinion in Hematology
Tannu Sahay, Charles A Schiffer

Abstract

Monitoring for residual leukemic burden is an integral part of ongoing evaluation in chronic myeloid leukemia. With high rates of complete cytogenetic response induced by imatinib and other tyrosine kinase inhibitors, exploring refinements in current methods of minimal residual disease monitoring is relevant. Estimation of leukemic burden can influence treatment decisions. Real-time RT-PCR has become the method of choice for quantifying bcr-abl transcripts in patients undergoing therapy. Efforts are in progress to standardize this technique. The numbers of bcr-abl transcripts can vary in serial specimens, and it is important that changes in treatment (e.g. referral for transplantation, imatinib dose increase, or switch to a new tyrosine kinase inhibitor) be based on consistent rises in transcript number over time rather than on a single change. Prognosis in newly diagnosed patients with chronic myeloid leukemia in chronic phase has dramatically improved with the availability of imatinib and other tyrosine kinase inhibitors. In parallel, methods of monitoring minimal residual disease are evolving. Although real-time RT-PCR is now a standard monitoring method, the clinical significance of frequent and more precise follow up in pa...Continue Reading

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