System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Review Ppublish 1247 citations

PubMed: 32127639 DOI: 10.1038/s41375-020-0776-2

European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia.

Leukemia 34(4):966-984

Authors: A Hochhaus, M Baccarani, R T Silver, C Schiffer, J F Apperley, F Cervantes, R E Clark, J E Cortes, M W Deininger, F Guilhot, H Hjorth-Hansen, T P Hughes, J J W M Janssen, H M Kantarjian, D W Kim, R A Larson, J H Lipton, F X Mahon, J Mayer, F Nicolini, D Niederwieser, F Pane, J P Radich, D Rea, J Richter, G Rosti, P Rousselot, G Saglio, S Saußele, S Soverini, J L Steegmann, A Turkina, A Zaritskey, R Hehlmann

Affiliations

  • Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany.
  • Department of Hematology/Oncology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
  • Weill Cornell Medical College, New York, NY, USA.
  • Karmanos Cancer Center, Detroit, MI, USA.
  • Hammersmith Hospital, Imperial College, London, UK.
  • Hospital Clinic IDIBAPS, Barcelona, Spain.
  • Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
  • Georgia Cancer Center, Augusta University, Augusta, GA, USA.
  • Huntsman Cancer Center Salt Lake City, Salt Lake City, UT, USA.
  • Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
  • Norwegian University of Science and Technology, Trondheim, Norway.
  • South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
  • Amsterdam University Medical Center, VUMC, Amsterdam, The Netherlands.
  • MD Anderson Cancer Center, Houston, TX, USA.
  • St. Mary´s Hematology Hospital, The Catholic University, Seoul, Korea.
  • University of Chicago, Chicago, IL, USA.
  • University of Toronto, Toronto, Canada.
  • Institut Bergonie, Université de Bordeaux, Bordeaux, France.
  • Department of Internal Medicine, Masaryk University Hospital, Brno, Czech Republic.
  • Centre Léon Bérard, Lyon, France.
  • Universitätsklinikum, Leipzig, Germany.
  • Department Clinical Medicine and Surgery, University Federico Secondo, Naples, Italy.
  • Fred Hutchinson Cancer Center, Seattle, WA, USA.
  • Hôpital St. Louis, Paris, France.
  • University of Lund, Lund, Sweden.
  • Centre Hospitalier de Versailles, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France.
  • University of Turin, Turin, Italy.
  • III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany.
  • Hospital de la Princesa, Madrid, Spain.
  • National Research Center for Hematology, Moscow, Russian Federation.
  • Almazov National Research Centre, St. Petersburg, Russian Federation.
  • III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany.
  • ELN Foundation, Weinheim, Germany.

Abstract

The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

MeSH

Leukemia, Myelogenous, Chronic, Bcr-Abl Positive, Therapeutics, Leukemia, Myeloid

Cited by