Updated concepts in the treatment of chronic myeloid leukemia in 2010

Abstract

In the last decade imatinib has became the drug of choice in the treatment of chronic myeloid leukemia (CML), and this fact was the starting point of targeted therapy in neoplastic malignancies. Clinical experience which has been achieved from this time allowed us for creation of a monitoring system and introducing new cathegories of response, like major or complete molecular response. During the same period it was possible to determine the time, when this should be achieved to get optimal therapeutic effect. Clinical experiences collected up to the year of 2005 allowed the panel of experts of the European LeukemiaNet published in 2006 recommendations for the management of CML patients. In the title of these recommendations the authors used the word “evolving” concepts, which means they would change in the future. In the coming years the new molecules with inhibitory activity against BCR-ABL1 tyrosine kinase were registered, including dasatinib and nilotinib. This was the main reason for revision of recommendations which were published at the end of 2009. In this article the author discussed the basis and reason of these changes. At the same article the problems of the therapy of CML, which are not yet solved are discussed. In the next years we can expect further evolution of these recommendations.
Hematologia 2010; 1, 3: 244-248