Chronic myelogenous leukemia, a still unsolved problem: pitfalls and new therapeutic possibilities

Drug Des Devel Ther. 2019 Mar 8:13:825-843. doi: 10.2147/DDDT.S191303. eCollection 2019.

Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of hematopoietic stem cells. At the molecular level, the disorder results from t(9;22)(q34;q11) reciprocal translocation between chromosomes, which leads to the formation of an oncogenic BCR-ABL gene fusion. Instead of progress in the understanding of the molecular etiology of CML and the development of novel therapeutic strategies, clinicians still face many challenges in the effective treatment of patients. In this review, we discuss the pathways of diagnosis and treatment of patients, as well as the problems appearing in the course of disease development. We also briefly refer to several aspects regarding the current knowledge on the molecular basis of CML and new potential therapeutic targets.

Keywords: BCR–ABL; CML; TKI; TKI withdrawal; autophagy; chronic myeloid leukemia; stem cells; tyrosine kinase inhibitors.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacology*
  • Dasatinib / pharmacology*
  • Fusion Proteins, bcr-abl / antagonists & inhibitors*
  • Fusion Proteins, bcr-abl / genetics
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics

Substances

  • Antineoplastic Agents
  • Fusion Proteins, bcr-abl
  • Dasatinib