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European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia

Hochhaus, A. ; Baccarani, M. ; Silver, R. T. ; Schiffer, C. ; Apperley, J. F. ; Cervantes, F. ; Clark, R. E. ; Cortes, J. E. ; Deininger, M. W. and Guilhot, F. , et al. (2020) In Leukemia 34(4). p.966-984
Abstract

The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be... (More)

The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Leukemia
volume
34
issue
4
pages
19 pages
publisher
Nature Publishing Group
external identifiers
  • scopus:85081568026
  • pmid:32127639
ISSN
0887-6924
DOI
10.1038/s41375-020-0776-2
language
English
LU publication?
yes
id
037eafe7-8594-4bfc-9053-9a8ff83a509e
date added to LUP
2020-03-27 09:50:35
date last changed
2024-06-13 13:30:54
@article{037eafe7-8594-4bfc-9053-9a8ff83a509e,
  abstract     = {{<p>The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.</p>}},
  author       = {{Hochhaus, A. and Baccarani, M. and Silver, R. T. and Schiffer, C. and Apperley, J. F. and Cervantes, F. and Clark, R. E. and Cortes, J. E. and Deininger, M. W. and Guilhot, F. and Hjorth-Hansen, H. and Hughes, T. P. and Janssen, J. J.W.M. and Kantarjian, H. M. and Kim, D. W. and Larson, R. A. and Lipton, J. H. and Mahon, F. X. and Mayer, J. and Nicolini, F. and Niederwieser, D. and Pane, F. and Radich, J. P. and Rea, D. and Richter, J. and Rosti, G. and Rousselot, P. and Saglio, G. and Saußele, S. and Soverini, S. and Steegmann, J. L. and Turkina, A. and Zaritskey, A. and Hehlmann, R.}},
  issn         = {{0887-6924}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{966--984}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Leukemia}},
  title        = {{European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia}},
  url          = {{http://dx.doi.org/10.1038/s41375-020-0776-2}},
  doi          = {{10.1038/s41375-020-0776-2}},
  volume       = {{34}},
  year         = {{2020}},
}