Title:Advances in the Treatment of Chronic Myeloid Leukemia
Volume: 19
Issue: 1
Author(s): Romeo G. Mihăilă*
Affiliation:
- Hematology Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, Sibiu, 550169, Romania
Keywords:
Asciminib, bone marrow microenvironment, chronic myeloid leukemia, deep molecular response, leukemic stem cells, treatment-free remission, tyrosine kinase inhibitors.
Abstract:
Background: The treatment of chronic myeloid leukemia has progressed in recent decades,
becoming a model for a disease whose pathogenesis is primarily based on a genetic mutation
and has led to survivals comparable to those of the general population.
Objectives: This review aims to present recent therapeutic advances in this area.
Methods: A mini-review was achieved using the articles published in Web of Science and Pub-
Med between January 2021 - May 2022, and new patents were made in this field.
Results: The three generations of tyrosine kinase inhibitors have transformed chronic myeloid
leukemia into a manageable disorder and greatly improved the treatment results of the chronic
phase, the prognosis, survival, and quality of life of patients. The therapeutic goals today include
achieving a deep and lasting molecular response as soon as possible, successful treatment-free remission,
and discovering and applying new therapeutic strategies to act on impaired immune
modulation and dormant leukemic stem cells. The allosteric inhibitor asciminib targets the ABL
myristoyl pocket, reduces Abl kinase activity, and is effective against most cells that have mutations
in the ABL1 kinase domain. Progress and recommendations for achieving long-term treatment-
free remission are set out. Nearly 50% of the patients who received first-line tyrosine kinase
inhibitors required a change of treatment by 10 years due to intolerance or resistance to treatment.
Their main side effects are presented.
Conclusion: Obtaining a deep and persistent molecular response contributes to achieving longterm
treatment-free remission.
