A combination of clinical and laboratory monitoring is needed for the optimal utilization of present therapeutic opportunities for patients who are diagnosed with chronic myeloid leukemia. The most delicate method of monitoring the effectiveness of tyrosine kinase inhibitor (TKI) treatment is by assessing the molecular response (MR) through a real-time quantitative polymerase chain reaction. Apart from the major molecular response which became a safe haven for survival after the beginning studies of first-line imatinib treatment, there are two new MR milestones that have been found as of recently: the deep molecular response and the early molecular response. During the therapy, the milestones were achieved inside specified points in time. As such, researchers thought that the success has opened the route to an optimum long-term solution. Plus, it could probably lead to a discontinuation of treatment successfully. In order to accurately inform and make better therapeutic decisions, sensitive and reproducible MR measurements are fundamental alongside the proper comprehension of the MR outcomes. A BCR-ABL1 mutation screening ought to be done on patients who do not happen to have a good response to TKI therapy since it might give some valuable information regarding the choice of TKI. Assisting clinicians in applying and interpreting the latest response definitions and clinical suggestions into practice is the main objective of this review. An analytical update regarding how clinical decision algorithms have incorporated MR levels on the basis of these recommendations and how to interpret BCR-ABL1 mutations upon detection is given.
Link:theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2015-0337
