Vol 1, No 3 (2010)
Review paper
Published online: 2010-07-27
Diagnosis and monitoring of chronic myeloid leukemia therapy
Hematologia 2010;1(3):219-228.
Abstract
The diagnosis of chronic myeloid leukemia (CML) is based on various techniques, including
morphology of peripheral blood and bone marrow, conventional karyotyping and different types
of polymerase chain reaction (PCR)-based methods. The phase of CML at diagnosis, revealed
by morphologic investigation, is the most important risk factor before introduction of therapy.
Additional cytogenetic abnormalities could have some prognostic significance and can be
detected by conventional karyotyping. PCR-based methods inform about the type and quantity
of BCR-ABL1 transcript. The goal of CML therapy is to reduce maximally the number of
leukemic cells, therefore, diagnostic methods used for therapy monitoring should have optimal sensitivity. The complete cytogenetic response (CCyR), achieved in the optimal time, is the
strongest and best confirmed measure of therapy success influencing progression free and
overall survival. Similar, but less documented value has the achievement of major molecular
response (MMolR). Early monitoring of BCR-ABL1 level after starting imatinib (IM) therapy
may be useful in predicting response, and subsequently, it could precede the relapse or
progression of the disease. In case of resistance, the analysis of ABL1 kinase mutations, IM
blood level or hOCT1 expression may help in future therapy choice decision making process.
Hematologia 2010; 1, 3: 219-228
Hematologia 2010; 1, 3: 219-228
Keywords: chronic myeloid leukemiadiagnosistreatment monitoring