Chronická myeloidní leukemie - aktuální léčebné možnosti
| Title in English | Chronic myeloid leukaemia - current treatment options |
|---|---|
| Authors | |
| Year of publication | 2022 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapie |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.farmakoterapie.cz/ |
| Keywords | chronic myeloid leukemia; tyrosine kinase inhibitors; treatment free remission |
| Description | The chronic myeloid leukaemia (CML) treatment is based on tyrosine kinase inhibitors targeted to BCR::ABL1 tyrosine kinase. Their introduction has extended the life expectancy of patients with newly diagnosed disease to the level of healthy peers and nowadays, CML has an excellent prognosis. For the chronic phase CML therapy, imatinib and nilotinib are available in the first line in the Czech Republic. Nilotinib induces responses more rapidly, but its administration may be associated with serious side effects such as metabolic disorders or even life-threatening vascular events. Therefore, its administration should be considered individually and in routine practice it is used rather in younger and less comorbid patients. In case of intolerance or resistance, dasatinib, bosutinib and ponatinib are available and asciminib, the only allosteric inhibitor, has been gradually moving into the clinical practice. The therapy of blast crisis is still unsuccessful and the administration of intensive chemotherapy and often allogeneic transplantation of hematopoietic stem cells is usually necessary to cure the patient. Treatment-free remission has become a new goal of CML therapy, which is currently reserved for patients with a sustained deep molecular response and is maintained in about half of these patients. However, this represents only a small fraction of CML patients, 10–20%. We therefore hope that the factors predicting successful treatment-free remission will be identified soon, and availability of this procedure will increase significantly. This paper comprehensively summarizes current treatment options including new promising drugs in clinical trials. |
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