Polish Adult Leukemia Group Recommendations for Diagnosis and Treatment of Chronic Myeloid Leukemia in 2013

Abstract

Tyrosine kinase inhibitors (TKIs) have dramatically improved the results of therapy of chronic myeloid leukemia. However the management with more potent second generation TKIs (2GTKIs) is required for imatinib-intolerant and imatinib-resistant patients. The frontline use of 2GTKIs results in higher rates of deeper and faster responses than with imatinib, it can enable many patients to qualify for participation in studies of treatment-free remission. The BCR/ABL transcript level at 3 months of TKI treatment has become a new prognostic factor. In this paper the recent clinical results of chronic myeloid leukemia therapy with imatinib in first line and with 2GTKIs in first and second line settings are reviewed, and updated PALG recommendations regarding the diagnosis, standard monitoring procedures, definitions of responses and treatment are presented.