Dr. Erba Discusses the Frontline Treatment of CML

Harry Erba, MD, PhD, associate professor, Department of Internal Medicine, University of Michigan Health System, explains that since the advent of a tyrosine-kinase inhibitor (TKI), such as imatinib, the first-line therapy for chronic myeloid leukemia (CML) has undergone drastic changes.

The frontline therapy for patients with newly diagnosed chronic-phase CML has moved away from allogeneic hematopoietic stem cell transplantation (HSCT) towards TKIs, which have fewer side effects. However, at this point the only known treatment that is potentially curative for CML is allogeneic HSCT.

The goal of this new first-line therapy is to prevent the disease from progressing to the accelerated or blast crisis phases. While in chronic-phase most patients are generally asymptomatic.

Patients that receive TKIs in the frontline generally experience complete cytogenetic responses. However, Erba explains that cytogenetic and molecular responses should be treated as surrogate endpoints that help determine if the patient will achieve long-term survival. These patients should be monitored closely for relapses.