nach oben

International Journal of Hematology

Erschienen in:

29.03.2021 | Progress in Hematology

Current status and novel strategy of CML

verfasst von: Kiyomi Morita, Koji Sasaki

Erschienen in: International Journal of Hematology | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

The advent of tyrosine kinase inhibitors (TKIs) has dramatically improved the outcome of patients with chronic myeloid leukemia (CML). Currently, four TKIs are available for the frontline treatment, including the first-generation TKI (imatinib) and the second-generation TKIs (dasatinib, nilotinib, and bosutinib). The second-generation TKIs lead to a faster and deeper molecular response without a survival benefit compared with imatinib. However, the opportunity for the treatment discontinuation and functional cure requires the achievement of durable deep molecular remission. Therefore, the second-generation TKIs should be considered as initial therapy for chronic-phase CML. Switch of therapy is warranted in case of treatment failure, including resistance and/or intolerance. The life expectancy of patients with CML is approaching that of the general population. Given an expected lifespan, future perspectives should consider the strategy for the optimal choice of TKIs, allowing for long-duration of effective TKI therapy with less toxicity to aim for a functional cure. A novel prediction approach such as artificial intelligence-driven analysis on the accumulated data from clinical trials paves a promising path for the personalized recommendation on frontline TKIs and precise survival prediction.

Rowley JD. Letter: a new consistent chromosomal abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature. 1973;243(5405):290–3.PubMed

Mandanas RA, Leibowitz DS, Gharehbaghi K, Tauchi T, Burgess GS, Miyazawa K, et al. Role of p21 RAS in p210 bcr-abl transformation of murine myeloid cells. Blood. 1993;82(6):1838–47.PubMed

Okuda K, Matulonis U, Salgia R, Kanakura Y, Druker B, Griffin JD. Factor independence of human myeloid leukemia cell lines is associated with increased phosphorylation of the proto-oncogene Raf-1. Exp Hematol. 1994;22(11):1111–7.PubMed

Raitano AB, Halpern JR, Hambuch TM, Sawyers CL. The Bcr-Abl leukemia oncogene activates Jun kinase and requires Jun for transformation. Proc Natl Acad Sci USA. 1995;92(25):11746–50.PubMedPubMedCentral

Sawyers CL, Callahan W, Witte ON. Dominant negative MYC blocks transformation by ABL oncogenes. Cell. 1992;70(6):901–10.PubMed

Shuai K, Halpern J, ten Hoeve J, Rao X, Sawyers CL. Constitutive activation of STAT5 by the BCR-ABL oncogene in chronic myelogenous leukemia. Oncogene. 1996;13(2):247–54.PubMed

Carlesso N, Frank DA, Griffin JD. Tyrosyl phosphorylation and DNA binding activity of signal transducers and activators of transcription (STAT) proteins in hematopoietic cell lines transformed by Bcr/Abl. J Exp Med. 1996;183(3):811–20.PubMed

Ilaria RL Jr, Van Etten RA. P210 and P190(BCR/ABL) induce the tyrosine phosphorylation and DNA binding activity of multiple specific STAT family members. J Biol Chem. 1996;271(49):31704–10.PubMed

Jabbour E, Cortes JE, Kantarjian HM. Molecular monitoring in chronic myeloid leukemia: response to tyrosine kinase inhibitors and prognostic implications. Cancer. 2008;112(10):2112–8.PubMed

10.

Kantarjian H, Schiffer C, Jones D, Cortes J. Monitoring the response and course of chronic myeloid leukemia in the modern era of BCR-ABL tyrosine kinase inhibitors: practical advice on the use and interpretation of monitoring methods. Blood. 2008;111(4):1774–80.PubMed

11.

Schoch C, Schnittger S, Bursch S, Gerstner D, Hochhaus A, Berger U, et al. Comparison of chromosome banding analysis, interphase- and hypermetaphase-FISH, qualitative and quantitative PCR for diagnosis and for follow-up in chronic myeloid leukemia: a study on 350 cases. Leukemia. 2002;16(1):53–9.PubMed

12.

Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the world health organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391–405.PubMed

13.

Ohanian M, Kantarjian HM, Shoukier M, Dellasala S, Musaelyan A, Gonzalez NGM et al. The clinical impact of time to response in de novo accelerated-phase chronic myeloid leukemia. Am J Hematol. 2020;95(10):1127–34.

14.

Jain P, Kantarjian HM, Ghorab A, Sasaki K, Jabbour EJ, Gonzalez GN, et al. Prognostic factors and survival outcomes in patients with chronic myeloid leukemia in blast phase in the tyrosine kinase inhibitor era: cohort study of 477 patients. Cancer. 2017;123(22):4391–402.PubMed

15.

Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE, et al. Prognostic discrimination in “good-risk” chronic granulocytic leukemia. Blood. 1984;63(4):789–99.PubMed

16.

Hasford J, Pfirrmann M, Hehlmann R, Allan NC, Baccarani M, Kluin-Nelemans JC, et al. A new prognostic score for survival of patients with chronic myeloid leukemia treated with interferon alfa. Writing Committee for the Collaborative CML Prognostic Factors Project Group. J Natl Cancer Inst. 1998;90(11):850–8.PubMed

17.

Hasford J, Baccarani M, Hoffmann V, Guilhot J, Saussele S, Rosti G, et al. Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score. Blood. 2011;118(3):686–92.PubMed

18.

Pfirrmann M, Baccarani M, Saussele S, Guilhot J, Cervantes F, Ossenkoppele G, et al. Prognosis of long-term survival considering disease-specific death in patients with chronic myeloid leukemia. Leukemia. 2016;30(1):48–56.PubMed

19.

Wang W, Cortes JE, Tang G, Khoury JD, Wang S, Bueso-Ramos CE, et al. Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy. Blood. 2016;127(22):2742–50.PubMedPubMedCentral

20.

Fabarius A, Leitner A, Hochhaus A, Muller MC, Hanfstein B, Haferlach C, et al. Impact of additional cytogenetic aberrations at diagnosis on prognosis of CML: long-term observation of 1151 patients from the randomized CML study IV. Blood. 2011;118(26):6760–8.PubMed

21.

Fabarius A, Kalmanti L, Dietz CT, Lauseker M, Rinaldetti S, Haferlach C, et al. Impact of unbalanced minor route versus major route karyotypes at diagnosis on prognosis of CML. Ann Hematol. 2015;94(12):2015–24.PubMed

22.

Morita K, Jabbour E, Ravandi F, Borthakur G, Khoury JD, Hu S et al. (2021) Clinical outcomes of patients with chronic myeloid leukemia with concurrent core binding factor rearrangement and philadelphia chromosome. Clin Lymphoma Myeloma Leuk. https://doi.org/10.1016/j.clml.2020.12.025. Online ahead of print.

23.

Issa GC, Kantarjian HM, Gonzalez GN, Borthakur G, Tang G, Wierda W, et al. Clonal chromosomal abnormalities appearing in Philadelphia chromosome-negative metaphases during CML treatment. Blood. 2017;130(19):2084–91.PubMedPubMedCentral

24.

Guo JQ, Lin H, Kantarjian H, Talpaz M, Champlin R, Andreeff M, et al. Comparison of competitive-nested PCR and real-time PCR in detecting BCR-ABL fusion transcripts in chronic myeloid leukemia patients. Leukemia. 2002;16(12):2447–53.PubMed

25.

Sasaki K. Chronic myeloid leukemia: update on treatment and survival prediction. Rinsho Ketsueki. 2020;61(9):1179–86.PubMed

26.

O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, et al. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2003;348(11):994–1004.PubMed

27.

Hochhaus A, Larson RA, Guilhot F, Radich JP, Branford S, Hughes TP, et al. Long-term outcomes of imatinib treatment for chronic myeloid leukemia. N Engl J Med. 2017;376(10):917–27.PubMedPubMedCentral

28.

Baccarani M, Druker BJ, Branford S, Kim DW, Pane F, Mongay L, et al. Long-term response to imatinib is not affected by the initial dose in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase: final update from the tyrosine kinase inhibitor optimization and selectivity (TOPS) study. Int J Hematol. 2014;99(5):616–24.PubMed

29.

Baccarani M, Rosti G, Castagnetti F, Haznedaroglu I, Porkka K, Abruzzese E, et al. Comparison of imatinib 400 mg and 800 mg daily in the frontline treatment of high-risk, Philadelphia-positive chronic myeloid leukemia: a European LeukemiaNet study. Blood. 2009;113(19):4497–504.PubMed

30.

Hehlmann R, Lauseker M, Saussele S, Pfirrmann M, Krause SW, Kolb HJ, et al. Final evaluation of randomized CML-study IV: 10-year survival and evolution of terminal phase. Blood. 2017;130:897. https://doi.org/10.1182/blood.V130.Suppl_1.897.897.CrossRef

31.

Sacha T, Gora-Tybor J, Szarejko M, Bober G, Grzybowska-Izydorczyk O, Niesiobedzka-Krezel J, et al. A multicenter prospective study on efficacy and safety of imatinib generics: a report from Polish Adult Leukemia Group imatinib generics registry. Am J Hematol. 2017;92(7):E125–8.PubMed

32.

Phukan A, Mandal PK, Dolai TK. Efficacy and safety profile of generic imatinib in patients with newly diagnosed chronic myeloid leukemia-chronic phase: sharing experience of a hemato-oncology center from eastern India. Ann Hematol. 2021;100(1):85–96.PubMed

33.

Abou Dalle I, Kantarjian H, Burger J, Estrov Z, Ohanian M, Verstovsek S, et al. Efficacy and safety of generic imatinib after switching from original imatinib in patients treated for chronic myeloid leukemia in the United States. Cancer Med. 2019;8(15):6559–65.PubMedPubMedCentral

34.

Kantarjian H, Shah NP, Hochhaus A, Cortes J, Shah S, Ayala M, et al. Dasatinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2010;362(24):2260–70.PubMed

35.

Cortes JE, Saglio G, Kantarjian HM, Baccarani M, Mayer J, Boque C, et al. Final 5-year study results of DASISION: the Dasatinib versus Imatinib study in treatment-naive chronic myeloid leukemia patients trial. J Clin Oncol. 2016;34(20):2333–40.PubMedPubMedCentral

36.

Radich JP, Kopecky KJ, Appelbaum FR, Kamel-Reid S, Stock W, Malnassy G, et al. A randomized trial of dasatinib 100 mg versus imatinib 400 mg in newly diagnosed chronic-phase chronic myeloid leukemia. Blood. 2012;120(19):3898–905.PubMedPubMedCentral

37.

O’Brien SG, Hedgley C, Adams S, Foroni L, Apperley JF, Holyoake TL, et al. Spirit 2: an NCRI randomised study comparing dasatinib with imatinib in patients with newly diagnosed CML. Blood. 2014;124(21):517. https://doi.org/10.1182/blood.V124.21.517.517.CrossRef

38.

Lombardo LJ, Lee FY, Chen P, Norris D, Barrish JC, Behnia K, et al. Discovery of N-(2-chloro-6-methyl- phenyl)-2-(6-(4-(2-hydroxyethyl)- piperazin-1-yl)-2-methylpyrimidin-4- ylamino)thiazole-5-carboxamide (BMS-354825), a dual Src/Abl kinase inhibitor with potent antitumor activity in preclinical assays. J Med Chem. 2004;47(27):6658–61.PubMed

39.

Saglio G, Kim DW, Issaragrisil S, le Coutre P, Etienne G, Lobo C, et al. Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med. 2010;362(24):2251–9.PubMed

40.

Kantarjian HM, Hughes TP, Larson RA, Kim DW, Issaragrisil S, le Coutre P, et al. Long-term outcomes with frontline nilotinib versus imatinib in newly diagnosed chronic myeloid leukemia in chronic phase: ENESTnd 10-year analysis. Leukemia. 2021;35(2):440–53.PubMedPubMedCentral

41.

Hughes TP, Saglio G, Larson RA, Kantarjian HM, Kim DW, Issaragrisil S, et al. Long-term outcomes in patients with chronic myeloid leukemia in chronic phase receiving frontline nilotinib versus imatinib: ENESTnd 10-year analysis. Blood. 2019;134:2924. https://doi.org/10.1182/blood-2019-128761.CrossRef

42.

Cortes JE, Gambacorti-Passerini C, Deininger MW, Mauro MJ, Chuah C, Kim DW, et al. Bosutinib versus imatinib for newly diagnosed chronic myeloid leukemia: results from the randomized BFORE trial. Journal Clin Oncol. 2018;36(3):231–7.

43.

Brummendorf TH, Cortes JE, Milojkovic D, Gambacorti-Passerini C, Clark RE, le Coutre PD, et al. Bosutinib (BOS) versus imatinib for newly diagnosed chronic phase (CP) chronic myeloid leukemia (CML): final 5-year results from the Bfore Trial. Blood. 2020;136. https://doi.org/10.1182/blood-2020-137393.

44.

O’Hare T, Shakespeare WC, Zhu X, Eide CA, Rivera VM, Wang F, et al. AP24534, a pan-BCR-ABL inhibitor for chronic myeloid leukemia, potently inhibits the T315I mutant and overcomes mutation-based resistance. Cancer Cell. 2009;16(5):401–12.PubMedPubMedCentral

45.

Cortes JE, Kim DW, Pinilla-Ibarz J, le Coutre P, Paquette R, Chuah C, et al. A phase 2 trial of ponatinib in Philadelphia chromosome-positive leukemias. N Engl J Med. 2013;369(19):1783–96.PubMed

46.

Cortes JE, Kim DW, Pinilla-Ibarz J, le Coutre PD, Paquette R, Chuah C, et al. Ponatinib efficacy and safety in Philadelphia chromosome-positive leukemia: final 5-year results of the phase 2 PACE trial. Blood. 2018;132(4):393–404.PubMedPubMedCentral

47.

Cortes JE, Lomaia E, Turkina A, Moiraghi B, Sutton MU, Pavlovsky C, et al. Interim analysis (IA) of OPTIC: a dose-ranging study of three ponatinib (PON) starting doses. J Clin Oncol. 2020;38(15):7502.

48.

Jain P, Kantarjian H, Boddu PC, Nogueras-Gonzalez GM, Verstovsek S, Garcia-Manero G, et al. Analysis of cardiovascular and arteriothrombotic adverse events in chronic-phase CML patients after frontline TKIs. Blood Adv. 2019;3(6):851–61.PubMedPubMedCentral

49.

Jain P, Kantarjian H, Sasaki K, Jabbour E, Dasarathula J, Nogueras Gonzalez G, et al. Analysis of 2013 European LeukaemiaNet (ELN) responses in chronic phase CML across four frontline TKI modalities and impact on clinical outcomes. Br J Haematol. 2016;173(1):114–26.PubMedPubMedCentral

50.

Jain P, Kantarjian H, Patel KP, Gonzalez GN, Luthra R, Shamanna RK, et al. Impact of BCR-ABL transcript type on outcome in patients with chronic-phase CML treated with tyrosine kinase inhibitors. Blood. 2016;127(10):1269–75.PubMedPubMedCentral

51.

Jain P, Kantarjian H, Alattar ML, Jabbour E, Sasaki K, Gonzalez GN, et al. Long-term molecular and cytogenetic response and survival outcomes with imatinib 400 mg, imatinib 800 mg, dasatinib, and nilotinib in patients with chronic-phase chronic myeloid leukaemia: retrospective analysis of patient data from five clinical trials. Lancet Haematol. 2015;2(3):e118-128.PubMedPubMedCentral

52.

Sasaki K, Lahoti A, Jabbour E, Jain P, Pierce S, Borthakur G, et al. Clinical safety and efficacy of nilotinib or dasatinib in patients with newly diagnosed chronic-phase chronic myelogenous leukemia and pre-existing liver and/or renal dysfunction. Clin Lymphoma Myeloma Leuk. 2016;16(3):152–62.PubMed

53.

Takahashi K, Kantarjian HM, Yang Y, Sasaki K, Jain P, DellaSala S, et al. A propensity score matching analysis of dasatinib and nilotinib as a frontline therapy for patients with chronic myeloid leukemia in chronic phase. Cancer. 2016;122(21):3336–43.PubMed

54.

Deininger MW, O’Brien SG, Ford JM, Druker BJ. Practical management of patients with chronic myeloid leukemia receiving imatinib. J Clin Oncol. 2003;21(8):1637–47.PubMed

55.

Talpaz M, Shah NP, Kantarjian H, Donato N, Nicoll J, Paquette R, et al. Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias. N Engl J Med. 2006;354(24):2531–41.PubMed

56.

Naqvi K, Jabbour E, Skinner J, Anderson K, Dellasala S, Yilmaz M, et al. Long-term follow-up of lower dose dasatinib (50 mg daily) as frontline therapy in newly diagnosed chronic-phase chronic myeloid leukemia. Cancer. 2020;126(1):67–75.PubMed

57.

Sasaki K, Strom SS, O’Brien S, Jabbour E, Ravandi F, Konopleva M, et al. Relative survival in patients with chronic-phase chronic myeloid leukaemia in the tyrosine-kinase inhibitor era: analysis of patient data from six prospective clinical trials. Lancet Haematol. 2015;2(5):e186-193.PubMedPubMedCentral

58.

Cortes JE, Jones D, O’Brien S, Jabbour E, Ravandi F, Koller C, et al. Results of dasatinib therapy in patients with early chronic-phase chronic myeloid leukemia. J Clin Oncol. 2010;28(3):398–404.PubMed

59.

Cortes JE, Jones D, O’Brien S, Jabbour E, Konopleva M, Ferrajoli A, et al. Nilotinib as frontline treatment for patients with chronic myeloid leukemia in early chronic phase. J Clin Oncol. 2010;28(3):392–7.PubMed

60.

Quintas-Cardama A, Kantarjian H, Jones D, Shan J, Borthakur G, Thomas D, et al. Delayed achievement of cytogenetic and molecular response is associated with increased risk of progression among patients with chronic myeloid leukemia in early chronic phase receiving high-dose or standard-dose imatinib therapy. Blood. 2009;113(25):6315–21.PubMedPubMedCentral

61.

Sasaki K, Kantarjian HM, Jain P, Jabbour EJ, Ravandi F, Konopleva M, et al. Conditional survival in patients with chronic myeloid leukemia in chronic phase in the era of tyrosine kinase inhibitors. Cancer. 2016;122(2):238–48.PubMed

62.

Sasaki K, Jabbour EJ, Ravandi F, Konopleva M, Borthakur G, Wierda WG et al. The leukemia artificial intelligence program (LEAP) in chronic myeloid leukemia in chronic phase: a model to improve patient outcomes. Am J Hematol. 2020;96(2):241–50.

63.

Jabbour E, Kantarjian H, O’Brien S, Shan J, Quintas-Cardama A, Faderl S, et al. The achievement of an early complete cytogenetic response is a major determinant for outcome in patients with early chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors. Blood. 2011;118(17):4541–6 (quiz 4759).PubMedPubMedCentral

64.

Kim DD, Lee H, Kamel-Reid S, Lipton JH. BCR-ABL1 transcript at 3 months predicts long-term outcomes following second generation tyrosine kinase inhibitor therapy in the patients with chronic myeloid leukaemia in chronic phase who failed Imatinib. Br J Haematol. 2013;160(5):630–9.PubMed

65.

Hochhaus A, Baccarani M, Silver RT, Schiffer C, Apperley JF, Cervantes F, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020;34(4):966–84.PubMedPubMedCentral

66.

Jabbour E, Branford S, Saglio G, Jones D, Cortes JE, Kantarjian HM. Practical advice for determining the role of BCR-ABL mutations in guiding tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia. Cancer. 2011;117(9):1800–11.PubMed

67.

Muller MC, Cortes JE, Kim DW, Druker BJ, Erben P, Pasquini R, et al. Dasatinib treatment of chronic-phase chronic myeloid leukemia: analysis of responses according to preexisting BCR-ABL mutations. Blood. 2009;114(24):4944–53.PubMedPubMedCentral

68.

Cortes J, Jabbour E, Kantarjian H, Yin CC, Shan J, O’Brien S, et al. Dynamics of BCR-ABL kinase domain mutations in chronic myeloid leukemia after sequential treatment with multiple tyrosine kinase inhibitors. Blood. 2007;110(12):4005–11.PubMed

69.

Hughes T, Saglio G, Branford S, Soverini S, Kim DW, Muller MC, et al. Impact of baseline BCR-ABL mutations on response to nilotinib in patients with chronic myeloid leukemia in chronic phase. J Clin Oncol. 2009;27(25):4204–10.PubMedPubMedCentral

70.

Matsumura I, Ohtake S, Atsuta Y, Kurata M, Minami Y, Takahashi N, et al. Nilotinib vs. dasatinib in achieving MR4.5 for newly diagnosed chronic myeloid leukemia: results of the prospective randomized phase 3 study, JALSG CML212. Blood. 2020;136:40–1.

71.

Lee SJ, Kukreja M, Wang T, Giralt SA, Szer J, Arora M, et al. Impact of prior imatinib mesylate on the outcome of hematopoietic cell transplantation for chronic myeloid leukemia. Blood. 2008;112(8):3500–7.PubMedPubMedCentral

72.

Nicolini FE, Basak GW, Kim DW, Olavarria E, Pinilla-Ibarz J, Apperley JF, et al. Overall survival with ponatinib versus allogeneic stem cell transplantation in Philadelphia chromosome-positive leukemias with the T315I mutation. Cancer. 2017;123(15):2875–80.PubMed

73.

Sasaki K, Kantarjian HM, O’Brien S, Ravandi F, Konopleva M, Borthakur G, et al. Incidence of second malignancies in patients with chronic myeloid leukemia in the era of tyrosine kinase inhibitors. Int J Hematol. 2019;109(5):545–52.PubMed

74.

Alfayez M, Richard-Carpentier G, Jabbour E, Vishnu P, Naqvi K, Sasaki K, et al. Sudden blastic transformation in treatment-free remission chronic myeloid leukaemia. Br J Haematol. 2019;187(4):543–5.PubMed

75.

Maiti A, Franquiz MJ, Ravandi F, Cortes JE, Jabbour EJ, Sasaki K, et al. Venetoclax and BCR-ABL tyrosine kinase inhibitor combinations: outcome in patients with Philadelphia chromosome-positive advanced myeloid leukemias. Acta Haematol. 2020;143(6):567–73.PubMed

76.

Shoukier M, Borthakur G, Jabbour E, Ravandi F, Garcia-Manero G, Kadia T et al. (2020) The effect of eltrombopag in managing thrombocytopenia associated with tyrosine kinase therapy in patients with chronic myeloid leukemia and myelofibrosis. Haematologica. https://doi.org/10.3324/haematol.2020.260125. Online ahead of print.

Titel: Current status and novel strategy of CML
verfasst von: Kiyomi Morita
Koji Sasaki
Publikationsdatum: 29.03.2021
Verlag: Springer Singapore
Erschienen in: International Journal of Hematology / Ausgabe 5/2021
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI: https://doi.org/10.1007/s12185-021-03127-5

Springer Medizin

Current status and novel strategy of CML

Abstract

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2021

Evolution of CML treatment

MPL exon 10 mutations other than canonical MPL W515L/K mutations identified by in-house MPL exon 10 direct sequencing in essential thrombocythemia

Pediatric blastic plasmacytoid dendritic cell neoplasm: report of four cases and review of literature

Impact of 2 Gy γ-irradiation on the hallmark characteristics of human bone marrow-derived MSCs

Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia/lymphoma with HTLV-1-associated myelopathy

Latest trends in the incidence of Helicobacter pylori-uninfected gastric mucosa-associated lymphoid tissue lymphoma at the Cancer Institute Hospital, Japan

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie