Chronic Myeloid Leukemia, Version 1.2019, NCCN Clinical Practice Guidelines in Oncology

J Natl Compr Canc Netw. 2018 Sep;16(9):1108-1135. doi: 10.6004/jnccn.2018.0071.

Abstract

Chronic myeloid leukemia (CML) is defined by the presence of Philadelphia chromosome (Ph), resulting from a reciprocal translocation between chromosomes 9 and 22 [t(9;22] that gives rise to a BCR-ABL1 fusion gene. CML occurs in 3 different phases (chronic, accelerated, and blast phase) and is usually diagnosed in the chronic phase. Tyrosine kinase inhibitor (TKI) therapy is a highly effective first-line treatment option for all patients with newly diagnosed chronic phase CML (CP-CML). The selection TKI therapy should be based on the risk score, toxicity profile of TKI, patient's age, ability to tolerate therapy, and the presence of comorbid conditions. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with CP-CML.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / standards
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / antagonists & inhibitors
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / isolation & purification
  • Bone Marrow / pathology
  • Clinical Trials as Topic
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Drug Resistance, Neoplasm / genetics
  • Fusion Proteins, bcr-abl / antagonists & inhibitors
  • Fusion Proteins, bcr-abl / genetics
  • Fusion Proteins, bcr-abl / isolation & purification
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality
  • Medical Oncology / methods
  • Medical Oncology / standards*
  • Patient Selection
  • Philadelphia Chromosome
  • Prognosis
  • Progression-Free Survival
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / standards
  • Protein Kinase Inhibitors / therapeutic use*
  • Real-Time Polymerase Chain Reaction / standards
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Societies, Medical / standards
  • United States

Substances

  • BCR-ABL1 fusion protein, human
  • Biomarkers, Tumor
  • Protein Kinase Inhibitors
  • Fusion Proteins, bcr-abl