Monitoring CML patients responding to treatment with tyrosine kinase inhibitors: review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results

摘要: The introduction in 1998 of imatinib mesylate (IM) revolutionized management patients with chronic myeloid leukemia (CML) and the second generation tyrosine kinase inhibitors may prove superior to IM. Real-time quantitative polymerase chain reaction (RQ-PCR) provides an accurate measure total leukemiacell mass degree which BCR-ABL transcripts are reduced by therapy correlates progression-free survival. Because a rising level is early indication loss response thus need reassess therapeutic strategy, regular molecular monitoring individual clearly desirable. Here we summarize results consensus meeting that took place at National Institutes Health (NIH) Bethesda October 2005. We make suggestions for (1) harmonizing differing methodologies measuring CML undergoing treatment using conversion factor whereby laboratories can express transcript levels on internationally agreed scale; (2) serial RQ-PCR rather than bone marrow cytogenetics or fluorescence situ hybridization (FISH) gene monitor responding treatment; (3) detecting reporting Philadelphia (Ph) chromosome-positive subpopulations bearing domain mutations. recognize our recommendations provisional will require revision as new evidence emerges. (Blood. 2006;108:28-37)