Practical considerations for monitoring patients with chronic myeloid leukemia.
Current routine monitoring strategies for chronic myeloid leukemia (CML) incorporate hematologic, cytogenetic, and molecular analysis. BCR-ABL1 kinase domain mutation analysis is an important assessment in specific circumstances. The recommendations for when and how frequently to undertake these assessments have recently been updated. However, response assessment is not always straightforward and access to some analytical tools may not be available. Pharmacokinetic assessment of imatinib levels may correlate with clinical response and could help in assessing issues of suboptimal response, excessive toxicity, or noncompliance. Here we provide practical considerations for monitoring response, offer suggestions for alternative assessments in case of failure or limited access of analyses, and consider future monitoring tools.
Branford
Susan
S
Department of Molecular Pathology and Centre for Cancer Biology, SA Pathology, School of Medicine, University of Adelaide, Adelaide, Australia. susan.branford@health.sa.gov.au
Hughes
Timothy P
TP
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D001549:Benzamides; D020732:Cytogenetic Analysis; D016903:Drug Monitoring; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis* / Q000188:drug therapy* / Q000201:enzymology; D009154:Mutation / Q000235:genetics; D010879:Piperazines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl