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Early Management of CML

  • Naranie ShanmuganathanEmail author
  • Timothy P. Hughes
Chronic Myeloid Leukemias (G Saglio, Section Editor)
  • 12 Downloads
Part of the following topical collections:
  1. Topical Collection on Chronic Myeloid Leukemias

Abstract

Purpose of Review

The marked improvement in clinical outcomes for patients with chronic myeloid leukaemia (CML) can be solely attributed to the introduction of targeted therapies against the fusion oncoprotein, BCR-ABL1. However, patient responses, although generally positive, remain heterogenous. Careful drug selection, ensuring the optimal TKI, is chosen for each patient and involves a complex decision process which incorporates consideration of numerous factors.

Recent Findings

For some patients, with disease characteristics that indicate adverse intrinsic disease biology, more potent BCR-ABL1 inhibition is often appropriate, whereas other patients with major co-morbidities will benefit from a less aggressive approach to avoid life-shortening toxicities. For the vast majority of patients, the long-term goal of therapy will be the achievement of a deep molecular response and subsequent treatment-free remission and this consideration will play a large part in the drug selection process.

Summary

We explore early management of CML, from the first presentation through to frontline therapy selection.

Keywords

TKI Deep molecular responses Drug toxicity Treatment-free remission 

Notes

Funding Information

N.S. received scholarship funding from the Royal Adelaide Hospital Research Foundation Dawes Scholarship. T.P.H. received support from the National Health and Medical Research Council of Australia (APP1135949) and has the financial support of Cancer Council SA’s Beat Cancer Project on behalf of its donors and the State Government of South Australia through the Department of Health.

Compliance with Ethical Standards

Conflict of Interest

N.S. received honoraria from Novartis and Bristol-Myers Squibb and travel and accommodation expenses from Novartis, Gilead, Amgen, and Janssen. T.P.H. holds a consultancy role in and has received research funding and honoraria from Novartis, Bristol-Myers Squibb, and Ariad.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Naranie Shanmuganathan
    • 1
    • 2
    • 3
    • 4
    • 5
    Email author
  • Timothy P. Hughes
    • 1
    • 2
    • 3
  1. 1.Precision Medicine ThemeSouth Australian Health and Medical Research InstituteAdelaideAustralia
  2. 2.School of MedicineUniversity of AdelaideAdelaideAustralia
  3. 3.Department of HaematologyRoyal Adelaide Hospital and SA PathologyAdelaideAustralia
  4. 4.Centre for Cancer BiologySA PathologyAdelaideAustralia
  5. 5.School of Health SciencesUniversity of South AustraliaAdelaideAustralia

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