Journal Article Review Epublish 17 citations
PubMed: 35158889 DOI: 10.3390/cancers14030620
Genomic Mechanisms Influencing Outcome in Chronic Myeloid Leukemia.
Cancers (Basel) 14(3)
Authors: Adelina Fernandes, Naranie Shanmuganathan, Susan Branford
Affiliations
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide 5000, Australia. School of Medicine, University of Adelaide, Adelaide 5000, Australia. Precision Medicine Theme, South Australian Health & Medical Research Institute (SAHMRI), Adelaide 5000, Australia.
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide 5000, Australia.
- School of Medicine, University of Adelaide, Adelaide 5000, Australia.
- Precision Medicine Theme, South Australian Health & Medical Research Institute (SAHMRI), Adelaide 5000, Australia.
- Department of Haematology, Royal Adelaide Hospital and SA Pathology, Adelaide 5000, Australia.
- School of Pharmacy and Medical Science, University of South Australia, Adelaide 5000, Australia.
Abstract
Chronic myeloid leukemia (CML) represents the disease prototype of genetically based diagnosis and management. Tyrosine kinase inhibitors (TKIs), that target the causal BCR::ABL1 fusion protein, exemplify the success of molecularly based therapy. Most patients now have long-term survival; however, TKI resistance is a persistent clinical problem. TKIs are effective in the BCR::ABL1-driven chronic phase of CML but are relatively ineffective for clinically defined advanced phases. Genomic investigation of drug resistance using next-generation sequencing for CML has lagged behind other hematological malignancies. However, emerging data show that genomic abnormalities are likely associated with suboptimal response and drug resistance. This has already been supported by the presence of kinase domain mutations in drug resistance, which led to the development of more potent TKIs. Next-generation sequencing studies are revealing additional mutations associated with resistance. In this review, we discuss the initiating chromosomal translocation that may not always be a straightforward reciprocal event between chromosomes 9 and 22 but can sometimes be accompanied by sequence deletion, inversion, and rearrangement. These events may biologically reflect a more genomically unstable disease prone to acquire mutations. We also discuss the future role of cancer-related gene mutation analysis for risk stratification in CML.
MeSH
Genes, Pharmaceutical Preparations, Leukemia, Leukemia, Myeloid, Leukemia, Myelogenous, Chronic, Bcr-Abl Positive, Mutation, Drug Resistance
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- The biology of chronic myeloid leukemia: an overview of the new insights and biomarkers. Front Oncol, 2025
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