Chronic Myelogenous Leukemia: Biology and Therapy

@article{Faderl1999ChronicML,
  title={Chronic Myelogenous Leukemia: Biology and Therapy},
  author={Stefan Faderl and Moshe Talpaz and Zeev E Estrov and Hagop Kantarjian},
  journal={Annals of Internal Medicine},
  year={1999},
  volume={131},
  pages={207-219}
}
Chronic myelogenous leukemia is a myeloproliferative disorder with clonal expansion of transformed primitive hematopoietic progenitor cells (1). It is characterized by a biphasicor triphasic clinical course in which a terminal blastic phase follows achronic phase of variable duration. The cytogenetic hallmark of chronicmyelogenous leukemia is the Philadelphia chromosome (Ph), a shortened chromosome 22 resulting from a translocation between the long arms of chromosome 9 and 22, t(9; 22)(q34; q11… 
Chronic Myelogenous Leukemia Chronic myelogenous leukemia
TLDR
CML is the most common of the myeloproliferative syndromes and the best characterized with regard to molecular abnormalities, resulting from a clonal expansion of cells with a Philadelphia chromosome producing a distinctive breakpoint cluster region— Abelson leukemia virus (BCR-ABL) fusion gene product.
Chronic myeloid leukemia in 2007.
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  • 2007
TLDR
The tests described here provide a comprehensive assessment of disease status allowing for effective patient management and understanding of BCR-ABL has allowed the development of therapies, which may keep patients with CML in chronic phase indefinitely.
Blastic phase of chronic myelogenous leukemia
TLDR
Currently, the most successful strategy for improving survival in CML is by prolonging the chronic phase and delaying the onset of blast crisis, and further studies of the mechanisms of transformation of chronic-phase CMLBC at a molecu-lar level, will determine the future direction of new treatment modalities.
Chronic Myeloid Leukemia - An Overview
TLDR
Future trials should compare the newer TKIs with high-dose imatinib as front-line treatment in newly diagnosed Chronic phase-CML patients and examine the option of discontinuing TKI after the achievement of complete molecular response.
Megakaryocytic blast crisis as a presenting manifestation of chronic myeloid leukemia.
Monitoring your patients with chronic myeloid leukemia.
  • J. Sessions
  • Biology, Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2006
TLDR
Polymerase chain reaction, the most sensitive of the assays, can be used to detect minute amounts of bcr-abl mRNA and this has made it possible to monitor and detect minimal residual disease recurrence and disease progression, thus greatly enhancing patient care.
Chronic Myelogenous Leukemia
TLDR
Morphologic, cytogenetic, and molecular studies are essential in the diagnosis and monitoring of patients with CML and newer chemotherapeutic agents and hematopoietic stem cell transplantation have substantially improved the prognosis.
Chronic myelogenous leukemia
TLDR
Through rational drug development, STI571, a bcr-abl tyrosine kinase inhibitor, has emerged as targeted therapy that offers new hope for expanded treatment options for patients with CML.
Accelerated and blastic phase of chronic myeloid leukemia
TLDR
Patients whose accelerated phase reverts to chronic phase after treatment may become candidates for bone marrow transplantation, and nontransplant regimens for accelerated phase that produce long-term benefit are urgently needed.
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References

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TLDR
This study determined whether achieving a cytogenetic response with interferon- therapy was independently related to prolonged survival in patients with chronic myelogenous leukemia.
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TLDR
It is important to confirm the diagnosis of CML by cytogenetic (Ph chromosome) or molecular studies, because the natural history and treatment of the myeloproliferative disorders are different.
The cytogenetic scenario of chronic myeloid leukemia.
TLDR
The four major route aberrations and the six minor route changes are present as part of the clonal evolution in 86% of CML with cytogenetic abnormalities in addition to the Ph chromosome.
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TLDR
It is demonstrated in 5/8 CML patients with blastic phase (BP) that the blood progenitor cells/(BPC) harvested during early recovery from marrow aplasia were Ph-negative on cytogenetic analysis, suggesting that leukapheresis may provide a useful source of 'normal' progenitors for subsequent reinfusions.
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TLDR
PSC collection during early hematopoietic recovery from intensive chemotherapy allowed the collection of diploid-rich stem cells, mostly in chronic-phase CML, and could be used for in vivo purging before autologous stem-cell transplantation (ASCT).
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TLDR
By providing an objective estimate of prognosis in accelerated disease, the model identifies patients in need of different therapeutic interventions before the development of blastic crisis and identified five features that have additive independent prognostic importance.
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TLDR
The most important observations relevant to understanding the oncogenic potential of the BCR-ABL chimeric gene, and the behaviour and the relationships of normal and leukemic stem cells are reported, and a therapeutic algorithm of a possible approach to the patients with untreated CML is provided.
Persistence of dormant leukemic progenitors during interferon-induced remission in chronic myelogenous leukemia. Analysis by polymerase chain reaction of individual colonies.
TLDR
The presence of a minority of Ph-positive CML progenitor cells for a very long period of time is still compatible with durable remission, confirming that a situation of tumor dormancy may be induced in CML by interferon therapy.
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