Diagnosis and treatment of chronic myeloid leukemia

Abstract

The original recognition of leukemia in the nineteenth century and the story of our progressive understanding of the biology and the development of treatment of chronic myeloid leukemia (CML) have been well reviewed in recent years (Goldman, Semin Hematol 47(4):302-11, 2010; Cortes and Kantarjian, Blood 120(7):1390-7, 2012; Hehlmann, Blood 120(4):737-47, 2012). Today, the diagnosis of CML usually presents few problems. In contrast, planning a therapeutic strategy for a patient who presents in chronic phase and monitoring a patient who starts treatment with a tyrosine kinase inhibitor (TKI) present a number of challenges. The same is true for a patient in chronic phase whose disease proves resistant to initial treatment with a TKI. Even more difficult may be the issue of how best to treat a patient presenting in or progressing to an advanced phase of CML. In this chapter, we review some of the essentials of diagnosis of CML with the main focus on the results of available treatment options and guidance on therapeutic strategy.