Abstract
Chronic myelogenous leukemia (CML) is a malignancy of the myeloid cell lineage characterized by a recurrent chromosomal abnormality: the Philadelphia chromosome, which results from the reciprocal translocation of the chromosomes 9 and 22. The Philadelphia chromosome contains a fusion gene called BCR-ABL1. The BCR-ABL1 codes for an aberrantly functioning tyrosine kinase that drives the malignant proliferation of the founding clone. The advent of tyrosine kinase inhibitors (TKI) represents a landmark in the treatment of CML, that has led to tremendous improvement in the remission and survival rates. Since the introduction of imatinib, the first TKI, several other TKI have been approved that further broadened the arsenal against CML. Patients treated with TKIs require sensitive monitoring of BCR-ABL1 transcripts with quantitative real-time polymerase chain reaction (qRT-PCT), which has become an essential part of managing patients with CML. In this review, we discuss the importance of the BCR-ABL1 assay, and we highlight the growing importance of BCR-ABL1 dynamics. We also introduce a mathematical correction for the BCR-ABL1 assay that could help homogenizing the use of the ABL1 as a control gene. Finally, we discuss the growing body of evidence concerning treatment-free remission. Along with the continuous improvement in the therapeutic arsenal against CML, the molecular monitoring of CML represents t
Authors
Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Department of Hematology, Ion Chiricuta Clinical Research Center, Cluj Napoca, Romania
Patric Teodorescu
Department of Hematology, Ion Chiricuta Clinical Research Center, Cluj Napoca, Romania
Department of Mathematics, Babes Bolyai University, Cluj Napoca, Romania
Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Department of Mathematics Babes-Bolyai University, Cluj-Napoca, Romania
Department of Hematology, Ion Chiricuta Clinical Research Center, Cluj Napoca, Romania
Department of Hematology, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology L. and A. Seràgnoli, S. Orsola-MalpighiUniversity Hospital, University of Bologna, Bologna, Italy
Keywords
chronic myeloid leukemia; mathematical modeling; BCR-ABL; IS; treatment free remission
Paper coordinates
V. Moisoiu, P. Teodorescu, L. Parajdi, S. Pasca, M. Zdrenghea, D. Dima, R. Precup, C. Tomuleasa, S. Soverini, Assessment of measurable residual disease in chronic myeloid leukemia. BCR-ABL1 IS in the avant-garde of molecular hematology, Frontiers in Oncology 9:863 (2019), https://doi.org/10.3389/fonc.2019.00863
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