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Minimal Residual Disease Eradication in CML: Does It Really Matter?

  • Chronic Myeloid Leukemias (J Pinilla-Ibarz, Section Editor)
  • Published:
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Abstract

BCR-ABL1 tyrosine kinase inhibitors (TKIs) have improved the prognosis of chronic phase chronic myeloid leukemia (CP-CML) to an extent that survival is largely determined by non-CML mortality. Monitoring for minimal residual disease by measuring BCR-ABL1 messenger RNA is a key component of CML management. CP-CML patients who achieve a stable deep molecular response may discontinue (TKIs) with an ~ 50% chance of entering treatment-free remission (TFR). So far discontinuation of TKIs has largely been limited to clinical trials, but is on the verge of becoming a part of wider clinical practice. Careful patient selection, dense molecular monitoring, and prompt reinstitution of treatment in the event of relapse are all vital to reproduce the same level of success. Much effort has been dedicated to identifying therapeutic strategies to eliminate CML stem cells and enable to TFR in more patients. Unfortunately, despite promising preclinical data, as yet, none of the various approaches have entered clinical practice.

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Authors and Affiliations

  1. Division of Hematology and Hematologic Malignancies, Huntsman Cancer Hospital, The University of Utah, Salt Lake City, UT, 84112, USA

    Srinivas K. Tantravahi, Raga S. Guthula, Thomas O’Hare & Michael W. Deininger

  2. Huntsman Cancer Institute, The University of Utah, Salt Lake City, 84112, USA

    Srinivas K. Tantravahi

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  1. Srinivas K. Tantravahi
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  2. Raga S. Guthula
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  3. Thomas O’Hare
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  4. Michael W. Deininger
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Correspondence to Srinivas K. Tantravahi.

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Conflict of Interest

Srinivas K. Tantravahi, Raga S. Guthula, and Thomas O’Hare each declare no potential conflicts of interest.

Michael W. Deininger reports personal fees from Ariad Pharmaceuticals, grants from Bristol Myers Squibb, personal fees from CTI BioPharma Corp, grants from Gilead, personal fees from Incyte, grants and personal fees from Novartis, grants and personal fees from Pfizer, grants from Celgene, personal fees from Blue Print, and personal fees from Galena, outside the submitted work.

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This article contains no studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Chronic Myeloid Luekemias

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Tantravahi, S.K., Guthula, R.S., O’Hare, T. et al. Minimal Residual Disease Eradication in CML: Does It Really Matter?. Curr Hematol Malig Rep 12, 495–505 (2017). https://doi.org/10.1007/s11899-017-0409-7

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  • DOI: https://doi.org/10.1007/s11899-017-0409-7

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