Optimizing Patient Care in Chronic Phase Chronic Myelogenous Leukemia: A Multidisciplinary Approach

Authors:
Hema Sundar From the National Comprehensive Cancer Network, Fort Washington, Pennsylvania; and Molecular Oncology Laboratory at Fred Hutchinson Cancer Research Center, and University of Washington School of Medicine, Seattle, Washington.

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 PhD
and
Jerald Radich From the National Comprehensive Cancer Network, Fort Washington, Pennsylvania; and Molecular Oncology Laboratory at Fred Hutchinson Cancer Research Center, and University of Washington School of Medicine, Seattle, Washington.

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Volume/Issue:
Volume 14: Issue suppl_1
Online Publication Date:
Jan 2016
DOI:
https://doi.org/10.6004/jnccn.2016.0197
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Chronic myelogenous leukemia (CML) is characterized by the presence of the Philadelphia chromosome arising from a reciprocal translocation between chromosomes 9 and 22 [t(9;22)]. This translocation results in the formation of the BCR-ABL fusion gene. The product of this fusion gene, p210, a protein with deregulated tyrosine kinase activity, plays a central role in the pathogenesis of CML. Tyrosine kinase inhibitor (TKI) therapy with small molecule inhibitors of BCR-ABL tyrosine kinase has significantly reduced the annual mortality rate among patients with CML. Although most of these patients respond to first-line TKI therapy, the use of TKIs is complicated by the development of resistance or intolerance in some patients, resulting in a loss of response or discontinuation of treatment. Inadequate response to TKI therapy is associated with poor long-term outcome, and the cases of patients with resistance or intolerance should be carefully evaluated for alternative treatment options. This report discusses the challenges associated with the management of newly diagnosed chronic phase CML in a patient with intolerance to multiple TKI therapies.

Correspondence: Hema Sundar, PhD, NCCN, 275 Commerce Drive, Suite 300, Fort Washington, PA. E-mail: sundar@nccn.org.
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2016 by the National Comprehensive Cancer Network 2016
Article Category:
Research Article
Print Publication Date:
01 Jan 2016
Online Publication Date:
Jan 2016

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