Optimising chronic myeloid leukaemia therapy in the face of resistance to tyrosine kinase inhibitors--a synthesis of clinical and laboratory data.

摘要: The introduction of imatinib, a tyrosine kinase inhibitor (TKI) that targets the BCR-ABL protein, has revolutionised treatment chronic myeloid leukaemia (CML), producing high rates response have been durable in many patients. However, because intrinsic or acquired mechanisms imatinib resistance, addition to persistence leukaemic stem cells are resistant imatinib-induced apoptosis, does not appear be curative. Cytogenetic and molecular monitoring enable identification patients showing signs failure can used guide choices regarding subsequent therapeutic options, including dose escalation, with secondary TKI or, selected cases, allogeneic cell transplant (allo-SCT). Although these alternative therapies may overcome long-term remission cure from CML is likely require development novel interventions effectively eliminate (Ph+HSC).