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Blood, 15 February 2008, Vol. 111, No. 4, pp. 1774-1780.
Prepublished online as a Blood First Edition Paper on November 30, 2007; DOI 10.1182/blood-2007-09-110189.
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Submitted September 13, 2007
Accepted November 16, 2007
Monitoring the response and course of chronic myeloid leukemia in the modern era of BCR-ABL tyrosine kinase inhibitors: practical advice on the use and interpretation of monitoring methods
Hagop Kantarjian*, Charles Schiffer, Dan Jones, and Jorge Cortes
Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, TX
Karmanos Cancer Institute, Division of Hematology/Oncology, Wayne State University School of Medicine, Detroit, MI
Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, TX
* Corresponding author; email: hkantarj{at}mdanderson.org.
The management of hematological malignancies, including chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), and acute lymphocytic leukemia (ALL), has led the way in establishing the use of regular laboratory testing to assess for residual disease on an ongoing basis. The goals of minimal residual disease (MRD) monitoring for leukemias include: 1) demonstration of the effectiveness of initial therapy; 2) monitoring for treatment resistance or relapse; and 3) dissecting the mechanisms of treatment failure to help in selection of alternative therapies. The underlying biology and range of treatment options for each leukemia type influences the methodologies used for MRD monitoring and the timing and duration of such monitoring. For example, flow cytometric monitoring plays a large role in MRD monitoring for ALL and CLL, whereas it is not used currently in CML. Here, we present an overview of the various approaches to monitoring CML, and with a practical summary of the current uses of molecular methodologies and their routine applications in clinical practice.
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