{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T15:31:14Z","timestamp":1721489474705},"reference-count":47,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Excellent therapeutic options exist for the treatment of chronic-phase chronic myeloid leukemia (CML) patients. Therefore, managing CML patients has become a more common practice for many physicians. Most chronic-phase CML patients achieve durable cytogenetic and molecular responses on first-line tyrosine kinase inhibitor therapy. However, careful monitoring and assessment of adherence are essential for successful outcomes and to identify patients at risk for failing therapy. The European LeukemiaNet and National Comprehensive Cancer Network provide guidance and strategies for monitoring and managing patients treated with TKIs. These recommendations continue to evolve as approved treatment options expand to include second- and third-generation tyrosine kinase inhibitors. How measurements of response are defined and data supporting recent recommended changes to monitoring are reviewed here. These changes include increasing recognition of the importance of early response. The relevance of achieving deep molecular responses will also be addressed.<\/jats:p>","DOI":"10.1182\/asheducation-2013.1.176","type":"journal-article","created":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T15:51:13Z","timestamp":1386345073000},"page":"176-183","update-policy":"http:\/\/dx.doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":9,"title":["Update on current monitoring recommendations in chronic myeloid leukemia: practical points for clinical practice"],"prefix":"10.1182","volume":"2013","author":[{"given":"Vivian G.","family":"Oehler","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"234","reference":[{"key":"2019111704225701400_B1","unstructured":"Howlader\n              N\n            \n            \n              Noone\n              AM\n            \n            \n              Krapcho\n              M\n            \n            \n          \n          National Cancer Institute Surveillance Epidemiology and End Results\n          Accessed May 1, 2013\n          \n            http:\/\/seer.cancer.gov\/statfacts\/html\/cmyl.html"},{"issue":"12","key":"2019111704225701400_B2","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.1002\/cncr.26679","article-title":"Estimations of the increasing prevalence and plateau prevalence of chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy","volume":"118","author":"Huang","year":"2012","journal-title":"Cancer"},{"issue":"35","key":"2019111704225701400_B3","doi-asserted-by":"crossref","first-page":"6041","DOI":"10.1200\/JCO.2009.25.0779","article-title":"Chronic myeloid leukemia: an update of concepts and management recommendations of European LeukemiaNet","volume":"27","author":"Baccarani","year":"2009","journal-title":"J Clin Oncol"},{"key":"2019111704225701400_B4","unstructured":"O'Brien\n              S\n            \n            \n              Abboud\n              CN\n            \n            \n              Akhtari\n              M\n            \n            \n          \n          NCCN Clinical Practice Guidelines in Oncology: Chronic myelogenous leukemia, version 4.2013\n          Accessed May 1, 2013\n          \n            http:\/\/www.nccn.org\/clinical.asp"},{"issue":"26","key":"2019111704225701400_B5","doi-asserted-by":"crossref","first-page":"6760","DOI":"10.1182\/blood-2011-08-373902","article-title":"Impact of additional cytogenetic aberrations at diagnosis on prognosis of CML: long-term observation of 1151 patients from the randomized CML Study IV","volume":"118","author":"Fabarius","year":"2011","journal-title":"Blood"},{"issue":"25","key":"2019111704225701400_B6","doi-asserted-by":"crossref","first-page":"6793","DOI":"10.1182\/blood-2011-01-328294","article-title":"Variant Philadelphia translocations: molecular-cytogenetic characterization and prognostic influence on frontline imatinib therapy, a GIMEMA Working Party on CML analysis","volume":"117","author":"Marzocchi","year":"2011","journal-title":"Blood"},{"issue":"16","key":"2019111704225701400_B7","doi-asserted-by":"crossref","first-page":"2748","DOI":"10.1200\/JCO.2009.26.7963","article-title":"Deletions of the derivative chromosome 9 do not influence the response and the outcome of chronic myeloid leukemia in early chronic phase treated with imatinib mesylate: GIMEMA CML Working Party analysis","volume":"28","author":"Castagnetti","year":"2010","journal-title":"J Clin Oncol"},{"issue":"22","key":"2019111704225701400_B8","doi-asserted-by":"crossref","first-page":"5085","DOI":"10.1002\/cncr.26147","article-title":"Prognostic impact of deletions of derivative chromosome 9 in patients with chronic myelogenous leukemia treated with nilotinib or dasatinib","volume":"117","author":"Quint\u00e1s-Cardama","year":"2011","journal-title":"Cancer"},{"issue":"10","key":"2019111704225701400_B9","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1038\/leu.2012.134","article-title":"Nilotinib vs imatinib in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase: ENESTnd 3-year follow-up","volume":"26","author":"Larson","year":"2012","journal-title":"Leukemia"},{"issue":"5","key":"2019111704225701400_B10","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1182\/blood-2011-08-376087","article-title":"Dasatinib or imatinib in newly diagnosed chronic-phase chronic myeloid leukemia: 2-year follow-up from a randomized phase 3 trial (DASISION)","volume":"119","author":"Kantarjian","year":"2012","journal-title":"Blood"},{"issue":"3","key":"2019111704225701400_B11","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1182\/blood-2010-12-319038","article-title":"Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score","volume":"118","author":"Hasford","year":"2011","journal-title":"Blood"},{"issue":"19","key":"2019111704225701400_B12","doi-asserted-by":"crossref","first-page":"3758","DOI":"10.1182\/blood-2010-03-273979","article-title":"Long-term prognostic significance of early molecular response to imatinib in newly diagnosed chronic myeloid leukemia: an analysis from the International Randomized Study of Interferon and STI571 (IRIS)","volume":"116","author":"Hughes","year":"2010","journal-title":"Blood"},{"issue":"8","key":"2019111704225701400_B13","doi-asserted-by":"crossref","first-page":"3330","DOI":"10.1182\/blood-2008-04-150680","article-title":"Desirable performance characteristics for BCR-ABL measurement on an international reporting scale to allow consistent interpretation of individual patient response and comparison of response rates between clinical trials","volume":"112","author":"Branford","year":"2008","journal-title":"Blood"},{"issue":"10","key":"2019111704225701400_B14","doi-asserted-by":"crossref","first-page":"2172","DOI":"10.1038\/leu.2012.104","article-title":"Standardized definitions of molecular response in chronic myeloid leukemia","volume":"26","author":"Cross","year":"2012","journal-title":"Leukemia"},{"issue":"9","key":"2019111704225701400_B15","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1038\/leu.2012.85","article-title":"Early molecular and cytogenetic response is predictive for long-term progression-free and overall survival in chronic myeloid leukemia (CML)","volume":"26","author":"Hanfstein","year":"2012","journal-title":"Leukemia"},{"issue":"3","key":"2019111704225701400_B16","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1200\/JCO.2011.38.6565","article-title":"Assessment of BCR-ABL1 transcript levels at 3 months is the only requirement for predicting outcome for patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors","volume":"30","author":"Marin","year":"2012","journal-title":"J Clin Oncol"},{"issue":"17","key":"2019111704225701400_B17","doi-asserted-by":"crossref","first-page":"4541","DOI":"10.1182\/blood-2011-04-348110","article-title":"The achievement of an early complete cytogenetic response is a major determinant for outcome in patients with early chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors","volume":"118","author":"Jabbour","year":"2011","journal-title":"Blood"},{"issue":"21","key":"2019111704225701400_B18","first-page":"167","article-title":"Outcome of patients with chronic myeloid leukemia in chronic phase (CML-CP) based on early molecular response and factors associated with early response: 4-year follow-up data from ENESTnd (Evaluating nilotinib efficacy and safety in clinical trials newly diagnosed patients) [abstract]","volume":"120","author":"Hochhaus","year":"2012","journal-title":"Blood (ASH Annual Meeting Abstracts)"},{"issue":"21","key":"2019111704225701400_B19","first-page":"1675","article-title":"Early response (molecular and cytogenetic) and long-term outcomes in newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP): exploratory analysis of DASISION 3-year data [abstract]","volume":"120","author":"Saglio","year":"2012","journal-title":"Blood (ASH Annual Meeting Abstracts)"},{"issue":"2","key":"2019111704225701400_B20","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1182\/blood-2012-01-407486","article-title":"Predictive value of early molecular response in patients with chronic myeloid leukemia treated with first-line dasatinib","volume":"120","author":"Marin","year":"2012","journal-title":"Blood"},{"issue":"8","key":"2019111704225701400_B21","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1182\/blood-2011-10-383000","article-title":"Responses to second-line tyrosine kinase inhibitors are durable: an intention-to-treat analysis in chronic myeloid leukemia patients","volume":"119","author":"Milojkovic","year":"2012","journal-title":"Blood"},{"issue":"35","key":"2019111704225701400_B22","doi-asserted-by":"crossref","first-page":"4323","DOI":"10.1200\/JCO.2011.40.5217","article-title":"Initial molecular response at 3 months may predict both response and event-free survival at 24 months in imatinib-resistant or -intolerant patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase treated with nilotinib","volume":"30","author":"Branford","year":"2012","journal-title":"J Clin Oncol"},{"issue":"6","key":"2019111704225701400_B23","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1038\/leu.2009.38","article-title":"Six-year follow-up of patients receiving imatinib for the first-line treatment of chronic myeloid leukemia","volume":"23","author":"Hochhaus","year":"2009","journal-title":"Leukemia"},{"issue":"7","key":"2019111704225701400_B24","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1002\/cncr.22936","article-title":"The prognosis for patients with chronic myeloid leukemia who have clonal cytogenetic abnormalities in Philadelphia chromosome-negative cells","volume":"110","author":"Deininger","year":"2007","journal-title":"Cancer"},{"issue":"12","key":"2019111704225701400_B25","doi-asserted-by":"crossref","first-page":"4437","DOI":"10.1182\/blood-2008-06-162388","article-title":"European LeukemiaNet criteria for failure or suboptimal response reliably identify patients with CML in early chronic phase treated with imatinib whose eventual outcome is poor","volume":"112","author":"Marin","year":"2008","journal-title":"Blood"},{"issue":"12","key":"2019111704225701400_B26","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1200\/JCO.2010.32.0598","article-title":"Tolerability-adapted imatinib 800 mg\/d versus 400 mg\/d versus 400 mg\/d plus interferon-alpha in newly diagnosed chronic myeloid leukemia","volume":"29","author":"Hehlmann","year":"2011","journal-title":"J Clin Oncol"},{"issue":"11","key":"2019111704225701400_B27","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S1470-2045(10)70233-3","article-title":"Discontinuation of imatinib in patients with chronic myeloid leukaemia who have maintained complete molecular remission for at least 2 years: the prospective, multicentre Stop Imatinib (STIM) trial","volume":"11","author":"Mahon","year":"2010","journal-title":"Lancet Oncol"},{"issue":"4","key":"2019111704225701400_B28","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1182\/blood-2013-02-483750","article-title":"Safety and efficacy of imatinib cessation for CML patients with stable undetectable minimal residual disease: results from the TWISTER Study","volume":"122","author":"Ross","year":"2013","journal-title":"Blood"},{"issue":"2","key":"2019111704225701400_B29","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1182\/blood-2012-07-441956","article-title":"Model-based decision rules reduce the risk of molecular relapse after cessation of tyrosine kinase inhibitor therapy in chronic myeloid leukemia","volume":"121","author":"Horn","year":"2013","journal-title":"Blood"},{"issue":"19","key":"2019111704225701400_B30","doi-asserted-by":"crossref","first-page":"3818","DOI":"10.1182\/blood-2012-10-462291","article-title":"Early molecular response and female sex strongly predict stable undetectable BCR-ABL1, the criteria for imatinib discontinuation in patients with CML","volume":"121","author":"Branford","year":"2013","journal-title":"Blood"},{"issue":"6","key":"2019111704225701400_B31","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1182\/blood-2013-05-501569","article-title":"European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013","volume":"122","author":"Baccarani","year":"2013","journal-title":"Blood"},{"issue":"11","key":"2019111704225701400_B32","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/S1470-2045(07)70342-X","article-title":"Part I: mechanisms of resistance to imatinib in chronic myeloid leukaemia","volume":"8","author":"Apperley","year":"2007","journal-title":"Lancet Oncol"},{"issue":"27","key":"2019111704225701400_B33","doi-asserted-by":"crossref","first-page":"5426","DOI":"10.1182\/blood-2009-08-215939","article-title":"Selecting optimal second-line tyrosine kinase inhibitor therapy for chronic myeloid leukemia patients after imatinib failure: does the BCR-ABL mutation status really matter?","volume":"114","author":"Branford","year":"2009","journal-title":"Blood"},{"issue":"15","key":"2019111704225701400_B34","doi-asserted-by":"crossref","first-page":"3403","DOI":"10.1182\/blood-2011-11-390120","article-title":"Bosutinib is active in chronic phase chronic myeloid leukemia after imatinib and dasatinib and\/or nilotinib therapy failure","volume":"119","author":"Khoury","year":"2012","journal-title":"Blood"},{"issue":"3","key":"2019111704225701400_B35","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1182\/blood-2012-05-431379","article-title":"BCR-ABL1 compound mutations in tyrosine kinase inhibitor-resistant CML: frequency and clonal relationships","volume":"121","author":"Khorashad","year":"2013","journal-title":"Blood"},{"issue":"13","key":"2019111704225701400_B36","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1182\/blood-2008-08-173674","article-title":"Determining the rise in BCR-ABL RNA that optimally predicts a kinase domain mutation in patients with chronic myeloid leukemia on imatinib","volume":"114","author":"Press","year":"2009","journal-title":"Blood"},{"issue":"10","key":"2019111704225701400_B37","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1182\/blood-2011-08-375535","article-title":"Poor response to second-line kinase inhibitors in chronic myeloid leukemia patients with multiple low-level mutations, irrespective of their resistance profile","volume":"119","author":"Parker","year":"2012","journal-title":"Blood"},{"issue":"22","key":"2019111704225701400_B38","doi-asserted-by":"crossref","first-page":"5401","DOI":"10.1182\/blood-2008-12-196543","article-title":"Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study","volume":"113","author":"Noens","year":"2009","journal-title":"Blood"},{"issue":"14","key":"2019111704225701400_B39","doi-asserted-by":"crossref","first-page":"3733","DOI":"10.1182\/blood-2010-10-309807","article-title":"Poor adherence is the main reason for loss of CCyR and imatinib failure for chronic myeloid leukemia patients on long-term therapy","volume":"117","author":"Ibrahim","year":"2011","journal-title":"Blood"},{"issue":"5","key":"2019111704225701400_B40","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.leukres.2010.10.017","article-title":"Exploring chronic myeloid leukemia patients' reasons for not adhering to the oral anticancer drug imatinib as prescribed","volume":"35","author":"Eliasson","year":"2011","journal-title":"Leuk Res"},{"issue":"6","key":"2019111704225701400_B41","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/ajh.22019","article-title":"Nonadherence to imatinib adversely affects event free survival in chronic phase chronic myeloid leukemia","volume":"86","author":"Ganesan","year":"2011","journal-title":"Am J Hematol"},{"issue":"1","key":"2019111704225701400_B42","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1185\/03007990903396469","article-title":"Healthcare resource utilization and costs associated with non-adherence to imatinib treatment in chronic myeloid leukemia patients","volume":"26","author":"Wu","year":"2010","journal-title":"Curr Med Res Opin"},{"issue":"7","key":"2019111704225701400_B43","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1038\/leu.2013.51","article-title":"Chronic fatigue is the most important factor limiting health-related quality of life of chronic myeloid leukemia patients treated with imatinib","volume":"27","author":"Efficace","year":"2013","journal-title":"Leukemia"},{"issue":"25","key":"2019111704225701400_B44","doi-asserted-by":"crossref","first-page":"5087","DOI":"10.1182\/blood-2012-09-458463","article-title":"Significant weight gain in patients with chronic myeloid leukemia after imatinib therapy","volume":"120","author":"Aduwa","year":"2012","journal-title":"Blood"},{"issue":"21","key":"2019111704225701400_B45","first-page":"1514","article-title":"A global retrospective and physician-based analysis of adherence to tyrosine kinase inhibitor (TKI) therapies for chronic myeloid leukemia (CML) [abstract]","volume":"116","author":"Guilhot","year":"2010","journal-title":"Blood (ASH Annual Meeting Abstracts)"},{"issue":"18","key":"2019111704225701400_B46","doi-asserted-by":"crossref","first-page":"4264","DOI":"10.1182\/blood-2011-11-393041","article-title":"BCR-ABL1 doubling times more reliably assess the dynamics of CML relapse compared with the BCR-ABL1 fold rise: implications for monitoring and management","volume":"119","author":"Branford","year":"2012","journal-title":"Blood"},{"key":"2019111704225701400_B47","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/978-1-60761-565-1_4","article-title":"Chronic myeloid leukemia","volume-title":"Leukemia and related disorders","author":"Coveler","year":"2012"}],"container-title":["Hematology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ashpublications.org\/hematology\/article-pdf\/2013\/1\/176\/1249416\/bep00113000176.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/ashpublications.org\/hematology\/article-pdf\/2013\/1\/176\/1249416\/bep00113000176.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,17]],"date-time":"2019-11-17T09:23:09Z","timestamp":1573982589000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/hematology\/article\/2013\/1\/176\/20730\/Update-on-current-monitoring-recommendations-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12,6]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12,6]]}},"URL":"https:\/\/doi.org\/10.1182\/asheducation-2013.1.176","relation":{},"ISSN":["1520-4391","1520-4383"],"issn-type":[{"value":"1520-4391","type":"print"},{"value":"1520-4383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,6]]}}}