Definition and treatment of resistance to tyrosine kinase inhibitors in chronic myeloid leukemia. Issue 3 (June 2014)

• Record Type: Journal Article
• Authors: Baccarani, Michele; Castagnetti, Fausto; Gugliotta, Gabriele; Palandri, Francesca; Rosti, Gianantonio
• Is Part Of: Expert review of hematology. Volume 7:Issue 3(2014)
• Page Start: 397
• Page End: 406
• Publication Date: 2014-06
• Subjects: Hematology -- Periodicals; 616.15005
• DOI: 10.1586/17474086.2014.900432
• Languages: English
• ISSNs: 1747-4086

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p>Resistance to tyrosine kinase inhibitors (TKIs) has many facets. The causes of resistance include low patient compliance, low plasma or intracellular drug concentration, BCR-ABL1 mutations, and clonal chromosome abnormalities in Ph+ cells, but in at least 50% of patients the causes are currently unknown. Primary resistance occurs when a predefined response level is not achieved within a prespecified period of time. Not achieving a complete hematologic response (CHR) within 3 months, not achieving a partial cytogenetic response and/or a <italic>BCR-ABL1</italic> transcripts level ≤10% (international standard) within 6 months, and not achieving a complete cytogenetic response (CCyR) and/or a <italic>BCR-ABL1</italic> transcripts level &lt;1% within 12 months, define primary resistance. Secondary resistance is defined by a loss of CHR, or CCyR, or major molecular response. Resistance to imatinib calls without exceptions for a second-generation TKI. In case of resistance to two TKIs, an allogeneic stem cell transplantation should be considered.</p> </abstract>