BJH - volume 6, issue 1, march 2015
F. S. Benghiat MD, PhD, Y. Beguin MD, PhD, B. Dessars MD, PhD, T. Devos MD, PhD, P. Lewalle MD, PhD, P. Mineur MD, N. Straetmans MD, PhD, K. Van Eygen MD, G. Verhoef MD, PhD, L. Knoops MD, PhD
Imatinib has drastically changed the outcome of patients with chronic myeloid leukaemia, with the majority of them showing a normal life span. Recently, the development of second and third generation tyrosine kinase inhibitors and the possibility of treatment discontinuation made the management of these patients more challenging. In this review, practical management guidelines of chronic myeloid leukaemia are presented adapted to the Belgian situation in 2014. In first line chronic phase patients, imatinib, nilotinib and dasatinib can be prescribed. While second generation tyrosine kinase inhibitors give faster and deeper responses, their impact on long-term survival remain to be determined. The choice of the tyrosine kinase inhibitor depends on chronic myeloid leukaemia risk score, priority for a deep response to allow a treatment-free remission protocol, age, presence of comorbid conditions, side effect profile, drug interactions, compliance concerns and price. Monitoring the response has to be done according the 2013 European LeukemiaNet criteria, and is based on the bone-marrow cytogenetic response during the first months and on the blood molecular response. Molecular follow-up is sufficient in patients with a complete cytogenetic response. For patients who fail frontline therapy, nilotinib, dasatinib, bosutinib and ponatinib are an option depending on the type of intolerance or resistance. T315I patients are only sensitive to ponatinib, which has to be carefully handled due to cardiovascular toxicity. Advanced phase diseases are more difficult to handle, with treatments including allogeneic stem cell transplantation, which is also an option for patients failing at least two tyrosine kinase inhibitors. The possibility of treatment-free remission and pregnancy are also discussed.
(BELG J HEMATOL 2015;6(1): 16–32)
Read moreBJH - volume 6, issue Abstract Book BHS, january 2015
J. Foguenne , M. Simul , R. Keutgens , F. Tassin , C. Bonnet MD, PhD, Y. Beguin MD, PhD, M. Jamar , F. Lambert MD, A. Gothot MD, PhD
BJH - volume 6, issue Abstract Book BHS, january 2015
G. Fransolet , G. Ehx , J. Somja MD, L. Belle , P-V. Drion , S. Humblet-Baron , Y. Beguin MD, PhD, B. Baron
BJH - volume 6, issue Abstract Book BHS, january 2015
M. Binsfeld , M. Hannon , S. Humblet-Baron , Y. Beguin MD, PhD, F. Baron MD, PhD, J. Caers MD, PhD
BJH - volume 6, issue Abstract Book BHS, january 2015
M. Hannon , Y. Beguin MD, PhD, G. Ehx , S. Servais MD, PhD, L. Seidel , C. Graux MD, PhD, J. Maertens MD, PhD, T. Kerre MD, PhD, C. Daulne , M. De Bock , M. Fillet , A. Ory , E. Willems MD, PhD, A. Gothot MD, PhD, S. Humblet-Baron , F. Baron MD, PhD
BJH - volume 6, issue Abstract Book BHS, january 2015
A. Jaspers MD, PhD, F. Baron MD, PhD, J. Maertens MD, PhD, B. De Prijck MD, R. Schots MD, PhD, C. Bonnet MD, PhD, K. Hafraoui , E. Willems MD, PhD, S. Servais MD, PhD, G. Fillet , Y. Beguin MD, PhD
BJH - volume 6, issue Abstract Book BHS, january 2015
M. Hannon , S. Servais MD, PhD, R. Schots MD, PhD, E. Castermans , L. Seidel , A. Gothot MD, PhD, E. Baudoux MD, O. Giet PhD, N. Wanten , E. Willems MD, PhD, C. Daulne , I. Van Riet PhD, Y. Beguin MD, PhD, F. Baron MD, PhD
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