European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia

Hochhaus, A, Baccarani, M, Silver, RT, Schiffer, C, Apperley, JF, Cervantes, F, Clark, RE ORCID: 0000-0002-1261-3299, Cortes, JE, Deininger, MW, Guilhot, F
et al (show 24 more authors) (2020) European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. LEUKEMIA, 34 (4). pp. 966-984.

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The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

Item Type: Article
Uncontrolled Keywords: Humans, Aniline Compounds, Nitriles, Pyrimidines, Quinolines, Fusion Proteins, bcr-abl, Antineoplastic Agents, Protein Kinase Inhibitors, Monitoring, Physiologic, Life Expectancy, Survival Analysis, Gene Expression, Quality of Life, Disease Management, Consensus Development Conferences as Topic, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Imatinib Mesylate, Clinical Decision-Making, Dasatinib
Depositing User: Symplectic Admin
Date Deposited: 13 Mar 2020 10:24
Last Modified: 21 Jan 2023 11:21
DOI: 10.1038/s41375-020-0776-2
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