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Evolving concepts in the management of chronic myeloid leukemia : recommendations from an expert panel on behalf of the European LeukemiaNet

Identifieur interne : 009F57 ( Main/Exploration ); précédent : 009F56; suivant : 009F58

Evolving concepts in the management of chronic myeloid leukemia : recommendations from an expert panel on behalf of the European LeukemiaNet

Auteurs : Michele Baccarani [Italie, États-Unis, Allemagne, Suède, Royaume-Uni, Espagne, Suisse, France, Australie] ; Giuseppe Saglio ; John Goldman ; Andreas Hochhaus ; Bengt Simonsson ; Frederick Appelbaum ; Jane Apperley ; Francisco Cervantes ; Jorge Cortes ; Michael Deininger ; Alois Gratwohl ; Francois Guilhot ; Mary Horowitz ; Timothy Hughes ; Hagop Kantarjian ; Richard Larson ; Dietger Niederwieser ; Richard Silver ; Rudiger Hehlmann

Source :

RBID : Pascal:06-0503292

Descripteurs français

English descriptors

Abstract

The introduction of imatinib mesylate (IM) has revolutionized the treatment of chronic myeloid leukemia (CML). Although experience is too limited to permit evidence-based evaluation of survival, the available data fully justify critical reassessment of CML management. The panel therefore reviewed treatment of CML since 1998. It confirmed the value of IM (400 mg/day) and of conventional allogeneic hematopoietic stem cell transplantation (alloHSCT). It recommended that the preferred initial treatment for most patients newly diagnosed in chronic phase should now be 400 mg IM daily. A dose increase of IM, alloHSCT, or investigational treatments were recommended in case of failure, and could be considered in case of suboptimal response. Failure was defined at 3 months (no hematologic response [HR]), 6 months (incomplete HR or no cytogenetic response [CgR]), 12 months (less than partial CgR [Philadelphia chromosome-positive (Ph+) > 35%]), 18 months (less than complete CgR), and in case of HR or CgR loss, or appearance of highly IM-resistant BCR-ABL mutations. Suboptimal response was defined at 3 months (incomplete HR), 6 months (less than partial CgR), 12 months (less than complete CgR), 18 months (less than major molecular response [MMoIR]), and, in case of MMoIR loss, other mutations or other chromosomal abnormalities. The importance of regular monitoring at experienced centers was highlighted.


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Le document en format XML

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<name sortKey="Appelbaum, Frederick" sort="Appelbaum, Frederick" uniqKey="Appelbaum F" first="Frederick" last="Appelbaum">Frederick Appelbaum</name>
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<name sortKey="Cervantes, Francisco" sort="Cervantes, Francisco" uniqKey="Cervantes F" first="Francisco" last="Cervantes">Francisco Cervantes</name>
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<name sortKey="Cortes, Jorge" sort="Cortes, Jorge" uniqKey="Cortes J" first="Jorge" last="Cortes">Jorge Cortes</name>
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<name sortKey="Deininger, Michael" sort="Deininger, Michael" uniqKey="Deininger M" first="Michael" last="Deininger">Michael Deininger</name>
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<name sortKey="Gratwohl, Alois" sort="Gratwohl, Alois" uniqKey="Gratwohl A" first="Alois" last="Gratwohl">Alois Gratwohl</name>
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<name sortKey="Guilhot, Francois" sort="Guilhot, Francois" uniqKey="Guilhot F" first="Francois" last="Guilhot">Francois Guilhot</name>
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<name sortKey="Horowitz, Mary" sort="Horowitz, Mary" uniqKey="Horowitz M" first="Mary" last="Horowitz">Mary Horowitz</name>
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<name sortKey="Hughes, Timothy" sort="Hughes, Timothy" uniqKey="Hughes T" first="Timothy" last="Hughes">Timothy Hughes</name>
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<name sortKey="Kantarjian, Hagop" sort="Kantarjian, Hagop" uniqKey="Kantarjian H" first="Hagop" last="Kantarjian">Hagop Kantarjian</name>
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<name sortKey="Larson, Richard" sort="Larson, Richard" uniqKey="Larson R" first="Richard" last="Larson">Richard Larson</name>
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<name sortKey="Niederwieser, Dietger" sort="Niederwieser, Dietger" uniqKey="Niederwieser D" first="Dietger" last="Niederwieser">Dietger Niederwieser</name>
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<name sortKey="Silver, Richard" sort="Silver, Richard" uniqKey="Silver R" first="Richard" last="Silver">Richard Silver</name>
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<name sortKey="Hehlmann, Rudiger" sort="Hehlmann, Rudiger" uniqKey="Hehlmann R" first="Rudiger" last="Hehlmann">Rudiger Hehlmann</name>
</author>
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<series>
<title level="j" type="main">Blood</title>
<title level="j" type="abbreviated">Blood</title>
<idno type="ISSN">0006-4971</idno>
<imprint>
<date when="2006">2006</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Blood</title>
<title level="j" type="abbreviated">Blood</title>
<idno type="ISSN">0006-4971</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Antineoplastic agent</term>
<term>Chronic myelocytic leukemia</term>
<term>Clinical management</term>
<term>Cohort study</term>
<term>Europe</term>
<term>Hematopoietic cell</term>
<term>Homograft</term>
<term>Human</term>
<term>Imatinib</term>
<term>Posology</term>
<term>Stem cell</term>
<term>Therapeutic protocol</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Leucémie myéloïde</term>
<term>Traitement</term>
<term>Conduite à tenir</term>
<term>Imatinib</term>
<term>Anticancéreux</term>
<term>Posologie</term>
<term>Homogreffe</term>
<term>Cellule hématopoïétique</term>
<term>Cellule souche</term>
<term>Protocole thérapeutique</term>
<term>Homme</term>
<term>Europe</term>
<term>Etude cohorte</term>
<term>Leucémie myéloïde chronique</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Cellule souche</term>
<term>Homme</term>
</keywords>
</textClass>
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<front>
<div type="abstract" xml:lang="en">The introduction of imatinib mesylate (IM) has revolutionized the treatment of chronic myeloid leukemia (CML). Although experience is too limited to permit evidence-based evaluation of survival, the available data fully justify critical reassessment of CML management. The panel therefore reviewed treatment of CML since 1998. It confirmed the value of IM (400 mg/day) and of conventional allogeneic hematopoietic stem cell transplantation (alloHSCT). It recommended that the preferred initial treatment for most patients newly diagnosed in chronic phase should now be 400 mg IM daily. A dose increase of IM, alloHSCT, or investigational treatments were recommended in case of failure, and could be considered in case of suboptimal response. Failure was defined at 3 months (no hematologic response [HR]), 6 months (incomplete HR or no cytogenetic response [CgR]), 12 months (less than partial CgR [Philadelphia chromosome-positive (Ph+) > 35%]), 18 months (less than complete CgR), and in case of HR or CgR loss, or appearance of highly IM-resistant BCR-ABL mutations. Suboptimal response was defined at 3 months (incomplete HR), 6 months (less than partial CgR), 12 months (less than complete CgR), 18 months (less than major molecular response [MMoIR]), and, in case of MMoIR loss, other mutations or other chromosomal abnormalities. The importance of regular monitoring at experienced centers was highlighted.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Bade-Wurtemberg</li>
<li>District de Karlsruhe</li>
<li>Grand Londres</li>
<li>Nouvelle-Aquitaine</li>
<li>Oregon</li>
<li>Piémont</li>
<li>Poitou-Charentes</li>
</region>
<settlement>
<li>Londres</li>
<li>Mannheim</li>
<li>Poitiers</li>
<li>Portland</li>
<li>Turin</li>
</settlement>
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<name sortKey="Appelbaum, Frederick" sort="Appelbaum, Frederick" uniqKey="Appelbaum F" first="Frederick" last="Appelbaum">Frederick Appelbaum</name>
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<name sortKey="Cervantes, Francisco" sort="Cervantes, Francisco" uniqKey="Cervantes F" first="Francisco" last="Cervantes">Francisco Cervantes</name>
<name sortKey="Cortes, Jorge" sort="Cortes, Jorge" uniqKey="Cortes J" first="Jorge" last="Cortes">Jorge Cortes</name>
<name sortKey="Deininger, Michael" sort="Deininger, Michael" uniqKey="Deininger M" first="Michael" last="Deininger">Michael Deininger</name>
<name sortKey="Goldman, John" sort="Goldman, John" uniqKey="Goldman J" first="John" last="Goldman">John Goldman</name>
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<name sortKey="Hochhaus, Andreas" sort="Hochhaus, Andreas" uniqKey="Hochhaus A" first="Andreas" last="Hochhaus">Andreas Hochhaus</name>
<name sortKey="Horowitz, Mary" sort="Horowitz, Mary" uniqKey="Horowitz M" first="Mary" last="Horowitz">Mary Horowitz</name>
<name sortKey="Hughes, Timothy" sort="Hughes, Timothy" uniqKey="Hughes T" first="Timothy" last="Hughes">Timothy Hughes</name>
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<name sortKey="Niederwieser, Dietger" sort="Niederwieser, Dietger" uniqKey="Niederwieser D" first="Dietger" last="Niederwieser">Dietger Niederwieser</name>
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<name sortKey="Silver, Richard" sort="Silver, Richard" uniqKey="Silver R" first="Richard" last="Silver">Richard Silver</name>
<name sortKey="Simonsson, Bengt" sort="Simonsson, Bengt" uniqKey="Simonsson B" first="Bengt" last="Simonsson">Bengt Simonsson</name>
</noCountry>
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<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</country>
<country name="Allemagne">
<region name="Bade-Wurtemberg">
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</region>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</country>
<country name="Suède">
<noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</noRegion>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</region>
</country>
<country name="Espagne">
<noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
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</country>
<country name="Suisse">
<noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
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</country>
<country name="France">
<region name="Nouvelle-Aquitaine">
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</region>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Baccarani, Michele" sort="Baccarani, Michele" uniqKey="Baccarani M" first="Michele" last="Baccarani">Michele Baccarani</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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