Current Perspectives on the Treatment of Patients with Chronic Myeloid Leukemia: An Individualized Approach to Treatment

Abstract

The BCR-ABL tyrosine kinase inhibitor imatinib has dramatically improved the prognosis for most patients with chronic myeloid leukemia (CML). Efforts to optimize therapy in CML have resulted in new and revised treatment guidelines or algorithms, which are reviewed here. Data were identified by searches of MEDLINE, PubMed, and references from relevant articles using the terms "chronic myeloid leukemia," "imatinib," and "tyrosine kinase inhibitors." Articles published in English between 1996 and 2006 were included. In this article we review consensus criteria for a therapeutic response and current expectations for CML therapy with imatinib, as well as the evidence supporting these recommendations. In addition, novel approaches to CML treatment are considered in light of the availability of second-generation tyrosine kinase inhibitors. With the advent of novel agents capable of treating imatinib-resistant or imatinib-intolerant CML, it should be possible in the future to further refine treatment algorithms.