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Annals of Hematology

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01.04.2015 | Review Article

A review of the European LeukemiaNet recommendations for the management of CML

verfasst von: Michele Baccarani, Fausto Castagnetti, Gabriele Gugliotta, Gianantonio Rosti

Erschienen in: Annals of Hematology | Sonderheft 2/2015

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Abstract

Several guidelines and recommendations on the management of chronic myeloid leukemia (CML) have been prepared by several scientific societies. The European LeukemiaNet (ELN) appointed a panel of experts who submitted their recommendations to peer-reviewed scientific journals in 2006, 2009, and 2013. Here, we make a critical review of the last, 2013, ELN recommendations, concerning the use of the five available tyrosine kinase inhibitors (TKIs), the evaluation of cytogenetic and molecular response, and the strategy of treatment. Three TKIs (imatinib, nilotinib, dasatinib) are recommended first-line. Bosutinib and ponatinib are available second-line; ponatinib is particularly indicated in case of the T315I mutation. Achieving an optimal response, not only for survival but also for a deeper, stable, treatment-free remission, requires a BCR-ABL transcripts level ≤10 % at 3 months, ≤1 % at 6 months, ≤0.1 % at 1 year, and ≤0.01 % later on. Molecular monitoring must include mutational analysis in every case of failure. A successful treatment of accelerated and blastic phase requires TKIs, and in many cases also allogeneic stem cell transplantation.

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Titel: A review of the European LeukemiaNet recommendations for the management of CML
verfasst von: Michele Baccarani
Fausto Castagnetti
Gabriele Gugliotta
Gianantonio Rosti
Publikationsdatum: 01.04.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe Sonderheft 2/2015
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-015-2322-2

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