Title:Emerging Therapies in Chronic Myeloid Leukemia
Volume: 12
Issue: 5
Author(s): J. Gora-Tybor
Affiliation:
Keywords:
Chronic myeloid leukemia, leukemic stem cells, tyrosine kinase inhibitors, ponatinib, aurora kinase inhibitors,
switch control inhibitors
Abstract: Chronic myeloid leukemia (CML) therapy has dramatically changed in the last decade due to the introduction
of tyrosine kinase inhibitors (TKIs) - imatinib, nilotinib and dasatinib. Despite the significant prolongation of overall
survival of CML patients there is still room for improvement. Approximately 20-25% of patients initially treated with
imatinib will need alternative therapy, due to drug resistance which is often caused by the appearance of clones expressing
mutant forms of BCR-ABL. Second generation TKIs dasatinib and nilotinib have shown promising results in imatinibresistant
or intolerant CML patients, but are not active against CML clones with highly resistant T315I mutation. In recent
years special attention is placed on small pool of leukemic stem cells which may contribute to the persistence of the
leukemia. This article provides a review of preclinical and clinical data concerning the most promising new directions in
CML treatment, with special emphasis on new drugs active in T315I mutation and compounds affecting leukemic stem
cells.
