title: The Role of Early Molecular Response in the Management of Chronic Phase CML.
abstract: Although tyrosine kinase inhibitors (TKIs) spectacularly improve the disease burden and the overall survival of chronic myeloid leukemia patients, early identification of a subset of poor TKI responders has been recognized as a critical goal to prevent disease progression in these patients. We herein review the past and recent evidence on the impact of early response.
  
  
  
  In the recent years, the achievement of an early molecular response (EMR, defined as 3-month BCR-ABL1 transcript <10% IS) has emerged as a useful tool to identify poor-risk patients. Although several groups have reported the importance of such milestone, clinical intervention based on it remains controversial partly due to its low specificity to predict progression, which may be partially improved by using the rate of decline in BCR-ABL1 transcript level (halving time or velocity of ratio reduction). Standardization of halving time or velocity of ratio reduction will likely help establishing more stringent recommendation and modify current clinical practices.
authors.affiliation: Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK.|Haematology Department, King's College London, London, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Harrington
authors.affiliation: Haematology Department, King's College London, London, UK.|Laboratory for Molecular Haemato-Oncology, King's College Hospital NHS Foundation Trust/King's College London, London, UK.
authors.forename: Aytug
authors.initials: A
authors.lastname: Kizilors
authors.affiliation: Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK. h.delavallade@nhs.net.|Haematology Department, King's College London, London, UK. h.delavallade@nhs.net.
authors.forename: Hugues
authors.initials: H
authors.lastname: de Lavallade
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D016044:Fusion Proteins, bcr-abl / Q000037:antagonists & inhibitors / Q000235:genetics; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D058990:Molecular Targeted Therapy; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D016044:Fusion Proteins, bcr-abl
keywords: CML; Chronic myeloid leukemias; Early molecular response; Tyrosine kinase inhibitors