title: Suboptimal responses in chronic myeloid leukemia: milestones and mechanisms.
abstract: Patients with chronic myeloid leukemia who fail to achieve timely treatment responses have a worse prognosis. Although many patients respond well to first-line treatment with imatinib, a significant proportion relapse or experience an inadequate response. Since effective alternative Bcr-Abl inhibitors are available (i.e., dasatinib or nilotinib), several regional groups have proposed milestones for imatinib failure or suboptimal response based on the achievement of specified levels of response within a defined treatment duration. A suboptimal response indicates that, although patients may continue to receive a benefit from continuing imatinib treatment at the assigned dose, long-term outcome may be better with an alternative strategy. The underlying mechanisms behind suboptimal responses are multifactorial and may differ from those causing relapse.
authors.affiliation: Department of Medicine (Division of Hematology), Helsinki University Central Hospital, Helsinki, Finland. kimmo.porkka@helsinki.fi
authors.forename: Kimmo
authors.initials: K
authors.lastname: Porkka
authors.forename: Satu
authors.initials: S
authors.lastname: Mustjoki
authors.forename: Bengt
authors.initials: B
authors.lastname: Simonsson
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use*; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate