Abstract
Chronic myelogenous leukemia, BCR-ABL1+ (CML) is a myeloproliferative neoplasm characterized by a BCRABL fusion gene and almost always exhibits the characteristic cytogenetic finding t(9;22)(q34;q11). The protein product of BCR-ABL1 is a constitutively active tyrosine kinase whose function is intrinsic to CML pathogenesis. Patients present with leukocytosis and often splenomegaly and prominent marrow hypercellularity with marked myeloid hyperplasia and basophilia in most cases. Unlike acute leukemias, the neoplastic myeloid cells in CML exhibit a full spectrum of maturation at the early stages of disease, but if untreated CML inexorably progresses to an acute leukemia. The recent development BCR-ABL1 tyrosine-kinase inhibitors has profoundly changed the clinical course of patients with CML; most patients achieve long-term remissions if they are treated in the early part of the disease course. Monitoring of resistance to tyrosine-kinase inhibitors and assessment for disease progression are critical in current CML management. Therapeutic approaches, including targeted therapy, is discussed.
Keywords: Chronic myelogenous leukemia, chronic myeloid leukemia, Philadelphia chromosome, BCR-ABL, imatinib, tyrosine kinase inhibitors, myeloproliferative neoplasms
Current Cancer Therapy Reviews
Title: Chronic Myelogenous Leukemia
Volume: 8 Issue: 1
Author(s): Robert P. Hasserjian
Affiliation:
Keywords: Chronic myelogenous leukemia, chronic myeloid leukemia, Philadelphia chromosome, BCR-ABL, imatinib, tyrosine kinase inhibitors, myeloproliferative neoplasms
Abstract: Chronic myelogenous leukemia, BCR-ABL1+ (CML) is a myeloproliferative neoplasm characterized by a BCRABL fusion gene and almost always exhibits the characteristic cytogenetic finding t(9;22)(q34;q11). The protein product of BCR-ABL1 is a constitutively active tyrosine kinase whose function is intrinsic to CML pathogenesis. Patients present with leukocytosis and often splenomegaly and prominent marrow hypercellularity with marked myeloid hyperplasia and basophilia in most cases. Unlike acute leukemias, the neoplastic myeloid cells in CML exhibit a full spectrum of maturation at the early stages of disease, but if untreated CML inexorably progresses to an acute leukemia. The recent development BCR-ABL1 tyrosine-kinase inhibitors has profoundly changed the clinical course of patients with CML; most patients achieve long-term remissions if they are treated in the early part of the disease course. Monitoring of resistance to tyrosine-kinase inhibitors and assessment for disease progression are critical in current CML management. Therapeutic approaches, including targeted therapy, is discussed.
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P. Hasserjian Robert, Chronic Myelogenous Leukemia, Current Cancer Therapy Reviews 2012; 8 (1) . https://dx.doi.org/10.2174/157339412799462486
DOI https://dx.doi.org/10.2174/157339412799462486 |
Print ISSN 1573-3947 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6301 |
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