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Management of chronic myeloid leukemia in 2023 - common ground and common sense.

Author: IssaGhayas C, JabbourElias, KantarjianHagop M, LiptonJeffrey H, RadichJerald P, SasakiKoji, SenapatiJayastu

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Overview

Treatment for chronic myeloid leukemia (CML) has evolved significantly, and the use of tyrosine kinase inhibitors (TKIs) has led to improved outcomes. While imatinib is the standard first-line therapy, newer second-generation TKIs like bosutinib, dasatinib, and nilotinib may achieve deeper molecular responses earlier, leading to a faster achievement of treatment-free remission (TFR). The choice of TKI depends on the patient's individual factors, including risk, treatment goals, cost, and side effects. In patients who are not candidates for TFR, low transcript levels (<1%) are acceptable and do not necessarily warrant changing the TKI. Third-generation TKIs are preferred for patients with resistance to second-generation TKIs or the T315I mutation. Ponatinib is a first-line option for T315I-mutated CML, while asciminib may have a better toxicity profile but less activity against T315I. Olverembatinib is a promising new third-generation TKI.
Paper Details　
Original Abstract of the Article :
With the improving knowledge of CML and its management, the goals of therapy need to be revisited to ensure an optimal use of the BCR::ABL1 TKIs in the frontline and later-line therapy of CML. In the frontline therapy of CML in the chronic phase (CML-CP), imatinib and the three second-generation TKI...See full text at original site
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引用元：
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10123066/

データ提供：米国国立医学図書館（NLM）

Navigating the Shifting Sands of Chronic Myeloid Leukemia Treatment

This research takes us on a journey through the constantly evolving field of hematology, focusing on the management of chronic myeloid leukemia (CML). The authors explore the optimal use of tyrosine kinase inhibitors (TKIs) in treating CML, highlighting the need for personalized treatment approaches based on patient factors such as disease risk and individual tolerance. The study emphasizes the use of second-generation TKIs for earlier deep molecular responses, leading to a shorter time to treatment-free remission (TFR). The study also discusses the importance of flexible dosing and careful management of toxicities, ensuring the best possible outcome for patients.

Second-Generation TKIs: A New Oasis in CML Treatment?

This study suggests that second-generation TKIs could be a valuable tool in the treatment of CML. It's like discovering a new oasis in the desert, offering the potential for faster and deeper remission. However, it's important to remember that every desert has its own challenges, and managing toxicities will be crucial to maximizing the benefits of these medications.

Living with CML: A Journey Through Shifting Sands

Managing CML requires a holistic approach that takes into account the individual needs of each patient. The study provides a framework for choosing the right TKI, optimizing dosing, and managing potential side effects. It's a reminder that the journey through the desert of CML treatment is unique for each individual, and requires careful navigation to reach the desired destination of sustained remission.

Dr.Camel's Conclusion

This research highlights the dynamic nature of CML treatment and the importance of personalized approaches to achieving optimal outcomes for patients. The findings offer a glimpse into the future of CML management, where individualized treatment strategies and careful monitoring are essential for navigating the shifting sands of this challenging disease.

Date :
  1. Date Completed 2023-04-25
  2. Date Revised 2023-05-10
Further Info :

Pubmed ID

37088793

DOI: Digital Object Identifier

PMC10123066

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Languages

English

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