Chronic Myelogenous Leukemia, Version 1.2014
- PMID: 24225967
- PMCID: PMC4234105
- DOI: 10.6004/jnccn.2013.0157
Chronic Myelogenous Leukemia, Version 1.2014
Abstract
The 2014 NCCN Clinical Practice Guidelines in Oncology for Chronic Myelogenous Leukemia recommend quantitative reverse-transcription polymerase chain reaction (QPCR) standardized to International Scale (IS) as the preferred method for monitoring molecular response to tyrosine kinase inhibitor (TKI) therapy. A BCR-ABL1 transcript level of 10% or less (IS) is now included as the response milestone at 3 and 6 months. Change of therapy to an alternate TKI is recommended for patients with BCR-ABL1 transcript levels greater than 10% (IS) at 3 months after primary treatment with imatinib. Continuing the same dose of TKI or switching to an alternate TKI are options for patients with BCR-ABL1 transcript levels greater than 10% (IS) at 3 months after primary treatment with dasatinib or nilotinib. The guidelines recommend 6-month evaluation with QPCR (IS) for patients with BCR-ABL1 transcript levels greater than 10% at 3 months. Monitoring with QPCR (IS) every 3 months is recommended for all patients, including those who meet response milestones at 3, 6, 12, and 18 months (BCR-ABL1 transcript level ≤10% [IS] at 3 and 6 months, complete cytogenetic response at 12 and 18 months).
Conflict of interest statement
The following authors have no relevant financial interests to disclose: Dr. Akharti, Dr. Jagasia, Dr. Pallera, and Dr. Reddy.
The following authors have disclosed the following relevant financial relationships:
Dr. Abboud: Advisory board member for ARIAD Pharmaceuticals, Inc. and Teva Pharmaceutical Industries Ltd.
Dr. Altman: PI for ARIAD Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; GlaxoSmithKline; Millennium Pharmaceuticals, Inc.; Astellas Pharma Inc.; Clavis Pharma; Cyclacel Pharmaceuticals, Inc.; CytRx Corporation; and Eli Lilly and Company. Advisory board member for ARIAD Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Celgene Corporation; and Genoptix.
Dr. Berman: Investigator for ARIAD Pharmaceuticals, Inc.
Dr. DeAngelo: Advisory board member for ARIAD Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Novartis Pharmaceuticals Corporation; and Sigma-Tau Pharmaceuticals, Inc.
Dr. Deininger: PI for ARIAD Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Celgene Corporation; Novartis Pharmaceuticals Corporation; and Gilead. Safety monitoring board for ARIAD Pharmaceuticals, Inc.; Novartis Pharmaceuticals Corporation; and Gilead. Research funding from Celgene Corporation, and lab research funding from Bristol-Myers Squibb Company; Novartis Pharmaceuticals Corporation; and Gilead. A consultant for ARIAD Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Novartis Pharmaceuticals Corporation; and Pfizer Inc. Advisory board member for ARIAD Pharmaceuticals, Inc.
Dr. Devine: Investigator for Genzyme Corporation. Advisory board member for GlaxoSmithKline.
Dr. Fathi: Advisory board member for Genzyme Corporation; Seattle Genetics, Inc.; Concert Pharmaceuticals, Inc.; and Teva Pharmaceutical Industries Ltd. Lecturer for Concert Pharmaceuticals, Inc.
Dr. Gotlib: Advisory board member for Novartis Pharmaceuticals Corporation.
Dr. Moore: Investigator for ARIAD Pharmaceuticals, Inc. and Novartis Pharmaceuticals Corporation. Research funding from Genentech, Inc. Advisory board member for Amgen Inc. Speakers bureau member for Genentech, Inc. Consultant for Novartis Pharmaceuticals Corporation.
Dr. O’Brien: PI for ARIAD Pharmaceuticals, Inc.; Infinity Pharmaceuticals, Inc.; and MorphoSys. Advisory board member for Teva Pharmaceutical Indus-tries Ltd.
Dr. Pinilla-Ibarz: PI for ARIAD Pharmaceuticals, Inc. and Novartis Pharmaceuticals Corporation. Advisory board member for ARIAD Pharmaceuticals, Inc.; Novartis Pharmaceuticals Corporation; and Pfizer Inc. Speakers bureau member for Cephalon, Inc.; Novartis Pharmaceuticals Corporation; and Pfizer Inc. Consultant for Bristol-Myers Squibb Company.
Dr. Radich: Consultant for Novartis Pharmaceuticals Corporation. Advisory board member for Novartis Pharmaceuticals Corporation and Pfizer Inc.
Dr. Shah: Consultant for ARIAD Pharmaceuticals, Inc. and Bristol-Myers Squibb Company.
Dr. Smith: Advisory board member for ARIAD Pharmaceuticals, Inc.; Clavis Pharma; and Teva Pharmaceutical Industries Ltd.
Dr. Snyder: Co-investigator for Bristol-Myers Squibb Company and Novartis Pharmaceuticals Corporation. Advisory board member for ARIAD Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; and Novartis Pharmaceuticals Corporation. Speakers bureau member for Bristol-Myers Squibb Company.
Dr. Wetzler: PI for Bristol-Myers Squibb Company. Advisory board member for Teva Pharmaceutical Industries Ltd.
The NCCN Guidelines Staff have no conflicts to disclose.
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