chronic%20myeloid%20leukemia
CHRONIC MYELOID LEUKEMIA

Chronic myelogenous leukemia (CML) is a malignant myeloid disorder characterized by the presence of a distinctive cytogenetic abnormality known as the Philadelphia chromosome.

Exposure to ionizing radiation is the only known risk factor with median presentation at age >50 years old.

Three phases of the disorder are chronic, accelerated and blast.

Choice of therapy is influenced by age, availability of a donor, comorbidities and phase of CML.

  1. American Cancer Society. What is chronic myeloid leukemia. American Cancer Society website. http://www.cancer.org/cancer/leukemia-chronicmyeloidcml/detailedguide/leukemia-chronic-myeloid-myelogenous-what-is-c-m-l. Feb 2016.
  2. Assouline S, Lipton JH. Monitoring response and resistance to treatment in chronic myeloid leukemia. Current Oncol. 2011 Apr;18(2):e71-e83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070714/pdf/conc-18-e71.pdf. PMID: 21505592
  3. Baccarani M, Castagnetti F, Gugliotta G. Treatment recommendations for chronic myeloid leukemia. Mediterr J Hematol Infect Disease. 2014 Jan;6(1):e2014005. doi: 10.4084/MJHID.2014.005.
  4. Baccarani M, Deininger MW, Rosti G, et al. European LeukemiaNet Recommendations for the management of chronic myeloid leukemia: 2013. Blood. 2013 Aug;122(6):872-884. doi: 10.1182/blood-2013-05-501569. PMID: 23803709
  5. Baccarani M, Pileri S, Steegmann JL, et al. Chronic myeloid leukemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2012 Oct;23(Suppl 7):vii72-vii77. doi:10.1093/annonc/mds228. PMID: 22997458
  6. Cancer Research UK. Types of treatment for chronic myeloid leukemia. Cancer Research UK website. http://www.cancerresearchuk.org/about-cancer/type/cml/treatment/which-treatment-for-chronic-myeloid-leukaemia. Nov 2014.
  7. Cross NC, White HE, Colomer D. Laboratory recommendations for scoring deep molecular responses following treatment for chronic myeloid leukemia. Leukemia. 2015 May;29(5):999-1003. doi: 10.1038/leu.2015.29. PMID: 25652737
  8. Deeg HJ, Sandmaier BM. Determining eligibility for hematopoietic cell transplantation. UptoDate website. http://www.uptodate.com/contents/determining-eligibility-for-allogeneic-hematopoietic-cell-transplantation/. Mar 2016.
  9. Hirji I, Gupta S, Goren A, et al. Chronic myeloid leukemia (CML): association of treatment satisfaction, negative medication experience and treatment restrictions with health outcomes, from the patient’s perspective. Health Qual Life Outcomes. 2013 Oct;11:167. doi: 10.1186/1477-7525-11-167. PMID: 24099272
  10. National Cancer Institute. General information about chronic myelogenous leukemia (CML). National Cancer Institute website. http://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq. Mar 2016.
  11. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: chronic myelogenous leukemia version 1.2016. NCCN website. https://www.nccn.org/professionals/physician_gls/pdf/cml.pdf. Sep 09, 2015.
  12. Negrin RS. Hematopoietic cell transplantation in chronic myeloid leukemia. UptoDate website. http://www.uptodate.com/contents/hematopoietic-cell-transplantation-in-chronic-myeloid-leukemia?source=see_link. Apr 2016.
  13. Negrin RS, Schiffer CA. Clinical use of tyrosine kinase inhibitors for chronic myeloid leukemia. UptoDate website. http://www.uptodate.com/contents/clinical-use-of-tyrosine-kinase-inhibitors-for-chronic-myeloid-leukemia?source=see_link. Feb 2016.
  14. Negrin RS, Schiffer CA. Overview of the treatment of chronic myeloid leukemia. UptoDate website. http://www.uptodate.com/contents/overview-of-the-treatment-of-chronic-myeloid-leukemia?source=search_result&search=Overview+of+the+ treatment+of+chronic+myeloid+leukemia&selected Title=1%7E150. Feb 2016.
  15. Negrin RS, Schiffer CA. Treatment of chronic myeloid leukemia in accelerated phase. UptoDate website. http://www.uptodate.com/contents/treatment-of-chronic-myeloid-leukemia-in-accelerated-phase?source=search_result&search=treatment+ of+chronic+myeloid+leukemia+in+accelerated +phase&selectedTitle=1%7E150. July 2015.
  16. Negrin RS, Schiffer CA. Treatment of myeloid leukemia in blast crisis. UptoDate website. http://www.uptodatecom/contents/treatment-of-chronic-myeloid-leukemia-in-blast-crisis? source=search_result&search=Treatment+of+chronic+ myeloid+leukemia+in+blast+crisis&selectedTitle=1~150. Sep 2014.
  17. Negrin RS, Schiffer CA. Treatment of chronic myeloid leukemia in chronic phase after failure of initial therapy. UptoDate website. http://www.uptodate.com/contents/treatment-of-chronic-myeloid-leukemia-in-chronic-phase-after-failure-of-initial-therapy?source=seelink§ionName=Omacetaxine&anchor=H24874435#H24874435. Apr 2016.
  18. Oehler VG. Update on current monitoring recommendations in chronic myeloid leukemia: practical points for clinical practice. Hematology Am Soc Hematol Educ Program. 2013;2013:176-183. doi: 10.1182/asheducation-2013.1.176. PMID: 24319179
  19. Rytting ME. Chronic myelogenous leukemia. MSD Manual. http://www.msdmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myelogenous-leukemia-cml. Oct 2014.
  20. Rochau U, Kluibenschaedl M, Stenehjem D, et al. Effectiveness and cost-effectiveness of sequential treatment of patients with chronic myeloid leukemia in the United States: a decision analysis. Leuk Res Treatment. 2015;2015:982395. doi: 10.1155/2015/982395. PMID: 26783469
  21. Van Etten RA. Cellular and molecular biology of chronic myeloid leukemia. UptoDate website. http://www.uptodate.com/contents/cellular-and-molecular-biology-of-chronic-myeloid-leukemia ?source=search_result&search=Cellular+and+molecular +biology+of+chronic+myeloid+leukemia& selectedTitle=1~150. Apr 2016.
  22. Van Etten RA. Clinical manifestations and diagnosis of chronic myeloid leukemia. UptoDate website. http://www.uptodate.com/contents/clinical-manifestations -and-diagnosis-of-chronic-myeloid-leukemia?source=search_result&search=clinical+manifestations+and+diagnosis+ of+chronic+myeloid+leukemia&selectedTitle=1~150. Apr 2016.
  23. Van Etten RA. Molecular genetics of chronic myeloid leukemia. UptoDate website. http://www.uptodate.com/contents/ molecular-genetics-of-chronic-myeloid-leukemia? source=search_result&search=Quantitative+ RT-PCR+%28QPCR%29&selectedTitle=5~150. Sep 2015.
  24. Waclaw J, Sacha T, Soklosa T. Imatinib in the treatment of chronic myeloid leukemia: Current perspectives on optimal dose. Cancer Therapy Advisor. http://www.cancertherapyadvisor.com/chronic-myeloid-leukemia/chronic-myeloid-leukemia-cml-imatinib-treatment- optimal-dosage/article/438571/. Sep 2015.
  25. World Health Organization. Chronic myelogenous leukemia. World Health Organization website. http://www.who.int/selection_medicines/committees/expert/20 /applications/CML.pdf?ua=1. 2014.
  26. National Comprehensive Cancer Network. NCCN Clinical practice guidelines in oncology (NCCN Guidelines): chronic myeloid leukemia. Version 1.2017. NCCN website. https://www.nccn.org/professionals/physician_gls/pdf/cml.pdf. 15 Nov 2016.
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