Chronic Myeloid Leukemia: Treatment

Jorge Cortes, MD, Director of the Georgia Cancer Center, discusses treatment options for chronic myeloid leukemia (CML). CML is a myeloproliferative neoplasm characterized by the expression of the BCR-ABL1 fusion gene. It presents with neutrophilic leukocytosis. Around 90% to 95% of patients have a shortened chromosome 22, or Philadelphia chromosome. The condition can manifest at any age but most commonly affects middle aged and older individuals. Patients usually present with fatigue, weight loss, anemia, night sweats, and splenomegaly. Approximately 50% of patients diagnosed with CML were asymptomatic and diagnosed due to routine complete blood count. Allogeneic stem cell transplantation and tyrosine kinase inhibitors are traditional first-lines of therapy for this condition. There are currently four U.S. Food and Drug Administration (FDA) approved tyrosine kinase inhibitors for first-line therapies for patients with CML: imatinib, bosutinib, dasatinib, and nilotinib. There are also several other therapies approved, or in development, as second- and third-line therapies for this rare cancer.