Recent developments in diagnostics and monitoring of tyrosine kinase inhibitors treatment response of chronic myeloid leukemia

Abstract

Techniques of molecular biology are of key importance in diagnostics and monitoring of tyrosine kinase inhibitors (TKIs) treatment response of chronic myeloid leukemia (CML). Although much has already been achieved in this field, new prognostic factors and developments in laboratory methods are constantly emerging.

Halving time is a new prognostic factor defined as the rate of BCR-ABL1 decline from baseline, assessed by estimating the number of days over which BCR-ABL1 halved. Among patients with >10% BCR-ABL1 at 3 months of therapy with TKI, the poorest-risk group can be distinguished by the slow rate of BCR-ABL1 decline from baseline. More common use of techniques, such as the whole exome sequencing and transcriptome sequencing will enable assessment of patients’ genetic variation at diagnosis and may contribute to a prognostic score that will allow for optimization of therapy. Digital PCR built on traditional PCR provides highly sensitive absolute quantification of BCR-ABL1 transcript level without the need for standard curves and could further improve the treatment results in patients with CML.