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Chronic myeloid leukaemia

Gianantonio Rosti, Fausto Castagnetti, Gabriele Gugliotta, Michele Baccarani
The therapeutic armamentarium for chronic myeloid leukaemia (CML) comprises mainly tyrosine kinase inhibitors (TKIs), with several agents available for frontline treatment, or for the treatment of disease resistance or intolerance to the first-choice or second-choice drug. The availability of different drugs is a major achievement, but means that choices must be made - which can be difficult and questionable at times. The most important end point considered in decision-making regarding treatment for any cancer is overall survival, but additional factors (such as age, prognostic category, safety, or the possibility of achieving treatment-free remission) should be considered when selecting an agent for frontline treatment...
October 18, 2016: Nature Reviews. Clinical Oncology
S Rajashree Nandagopalan, Nivedita Kuila, Sutapa Biswas, Naresh Chandra Pattnayak, Gyanashyam Biswas, Soumen Chakraborty
BACKGROUND & OBJECTIVES: Chronic myeloid leukaemia is (CML) characterized by the presence of a hallmark chromosomal translocation, the Philadelphia chromosome. Although there are many reports available regarding the different variants of BCR-ABL in CML, we studied the co-expression of e13a2 and e14a2 transcripts and a few polymorphisms in CML patients. METHODS: Molecular genetics approach was adapted to screen for polymorphisms, mutation and translocation in BCR, ABL kinase domain and BCR-ABL breakpoint region in 73 CML patients...
May 2016: Indian Journal of Medical Research
Lincy Vinayan M, Usha Padmini, Balamurughan, Selvamani, K Sivakumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Lincy Vinayan M, Usha Padmini, Balamurughan, Selvamani, K Sivakumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Massimo Breccia, Patrizia Pregno, Paolo Spallarossa, Eleonora Arboscello, Fabio Ciceri, Mauro Giorgi, Alberto Grossi, Mario Mallardo, Savina Nodari, Stefano Ottolini, Carla Sala, Giovanni Tortorella, Gianantonio Rosti, Fabrizio Pane, Giorgio Minotti, Michele Baccarani
Ponatinib (Iclusig, ARIAD Pharmaceuticals-Incyte Co.) is a third-generation structure-guided tyrosine kinase inhibitor that is approved for treatment of Philadelphia chromosome-positive leukaemias resistant or intolerant to other inhibitors. The clinical use of ponatinib is complicated by the possible development of cardiovascular events, primarily hypertension and arterial or venous thrombotic events. The US Food and Drug Administration and the European Medicine Agency recommend that the cardiovascular profile of patients candidate for ponatinib should be carefully evaluated...
September 30, 2016: Annals of Hematology
Anne Willerslev, Mathias M Hansen, Oliver Niels Klefter, Ole Weis Bjerrum, Hans C Hasselbalch, Stine N Clemmensen, Michael Larsen, Inger Christine Munch
PURPOSE: To study the circulation in the retinal vessels in patients with blood dyscrasia due to myeloproliferative neoplasms using non-invasive retinal imaging. METHODS: Prospective consecutive case series of seven treatment-naïve patients with chronic myeloid leukaemia (n = 2), polycythemia vera (n = 4), essential thrombocytosis (n = 1) examined before and after cytoreductive treatment. We investigated retinal circulation with motion-contrast imaging, retinal oximetry and spectral-domain optical coherence tomography...
September 29, 2016: Acta Ophthalmologica
Maria A Karalexi, Margarita Baka, Anton Ryzhov, Anna Zborovskaya, Nadya Dimitrova, Snezana Zivkovic, Sultan Eser, Luis Antunes, Mario Sekerija, Tina Zagar, Joana Bastos, Anna Demetriou, Domenic Agius, Margareta Florea, Daniela Coza, Sophia Polychronopoulou, Eftichia Stiakaki, Maria Moschovi, Emmanuel Hatzipantelis, Maria Kourti, Stelios Graphakos, Maria S Pombo-de-Oliveira, Hans Olov Adami, Eleni Th Petridou
AIM: To assess trends in survival and geographic disparities among children (0-14 years) with chronic myeloid leukaemia (CML) before and after the introduction of molecular therapy, namely tyrosine kinase inhibitors (TKIs) in Southern-Eastern European (SEE) countries and the USA. METHODS: We calculated survival among children with CML, acute lymphoblastic (ALL) and acute myeloid leukaemia (AML) in 14 SEE (1990-2014) cancer registries and the U.S. Surveillance, Epidemiology and End Results Program (SEER, 1990-2012)...
November 2016: European Journal of Cancer
Ankur Jain, Naresh Gupta, Tejinder Singh, Sunita Agarwal
INTRODUCTION: Chronic Myeloid Leukaemia (CML) is characterized by derangement of various components of the haemostatic system resulting in thrombo-haemorrhagic complications. Although less common than other myeloproliferative neoplasms, derangement of various components of the haemostatic system is observed in CML. Haemostatic abnormalities have been described in relation to hyperleucostasis and drugs used to treat CML. However, the correlation between haemostatic derangements and phase of CML is unclear in the literature...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Gareth Gerrard, Hui En Foong, Katherine Mudge, Mary Alikian, Jane F Apperley, Letizia Foroni
Molecular monitoring of BCR-ABL1 expression in chronic myeloid leukaemia (CML) is well established. As the International Scale (IS) normalised BCR-ABL1/ABL1 ratio at 3 months post-treatment is now an important milestone in patients' treatment schedule, the reliable and reproducible measurement of BCR-ABL1 levels is therefore paramount. IS conversion factors (CF) are established via sample exchange and yearly ratification with an external reference laboratory. Since any change to an established IS CF could lead to discontinuity in longitudinal results, we wished to add an internal verification step as an additional safeguard...
October 2016: Leukemia Research
Laura N Eadie, Timothy P Hughes, Deborah L White
The tyrosine kinase inhibitor (TKI) imatinib has resulted in excellent responses in the majority of Chronic Myeloid Leukaemia (CML) patients; however, resistance is observed in 20-30% of patients. More recently, resistance to the second generation TKIs, nilotinib and dasatinib, has also been observed albeit at a lower incidence. ABCB1 has previously been implicated in TKI export and its overexpression linked to TKI resistance. In this study the dynamics of nilotinib resistance was studied in CML cell lines with particular focus on ABCB1 expression levels during development of resistance...
2016: PloS One
Hanna Renshaw, Shreyans Gandhi, Asad Shah, Robin Ireland, Judith C Marsh, Ghulam J Mufti
No abstract text is available yet for this article.
October 2016: British Journal of Haematology
Sara Basbous, Anaïs Levescot, Nathalie Piccirilli, Françoise Brizard, François Guilhot, Lydia Roy, Nicolas Bourmeyster, Jean-Marc Gombert, André Herbelin
CD1d-restricted iNKT cells are believed to play a key role in cancer immune surveillance and are functionally deficient in chronic myeloid leukaemia (CML). Herein, we have hypothesized that this defect might originate from BCR-ABL-dependent dysfunctions in myeloid dendritic cells (mDCs). Indeed, flow cytometry and confocal microscopy revealed that cell surface expression of CD1d was downregulated in CML mDCs, relative to healthy donor (HD) controls. The decreased cell surface display of CD1d could not be ascribed to defective mDC differentiation, as attested by normal expression of HLA-DR and the CD86 maturation marker...
August 11, 2016: Journal of Pathology
Aneesha Hossain, Kanika Gupta, Andrew Mener, Imad Tabbara
A woman aged 42 years with a 1-month history of rapidly expanding bilateral breast masses presented with severe leucocytosis, anaemia, blurry vision, headaches and shortness of breath. Evaluation revealed chronic myeloid leukaemia in lymphoid blast crisis with extramedullary leukaemia involving her breasts.
2016: BMJ Case Reports
Krupa Shah, Sonia Parikh, Rakesh Rawal
Chronic myeloid leukaemia (CML) is a clonal myeloproliferative hematopoietic stem cell disorder. Deregulated BCRABL fusion tyrosine kinase activity is the main cause of CML disease pathogenesis, making BCRABL an ideal target for inhibition. Current tyrosine kinase inhibitors (TKIs) designed to inhibit BCRABL oncoprotein activity, have completely transformed the prognosis of CML. Interruption of TKI treatment leads to minimal residual disease reside (MRD), thought to reside in TKIinsensitive leukaemia stem cells which remain a potential reservoir for disease relapse...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Wenli Zuo, Sa A Wang, Courtney DiNardo, Mariko Yabe, Shaoying Li, L Jeffrey Medeiros, Guilin Tang
AIMS: Chromosome 11q23 translocations, resulting in MLL (KMT2A) rearrangement, have been well characterised in acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL). However, little is known of haematopoietic neoplasms associated with 11q23 translocation but without MLL rearrangement (11q23+/MLL-). The aim of this study is to characterise such cases with 11q23+/MLL-. METHODS AND RESULTS: We retrospectively searched our database for cases with haematopoietic malignancies with 11q23+/MLL-...
August 5, 2016: Journal of Clinical Pathology
Naif Alhawiti, Kate L Burbury, Faith A Kwa, Cindy J O'Malley, Peter Shuttleworth, Mohamad Alzard, Abdullah Hamadi, Andrew P Grigg, Denise E Jackson
Tyrosine kinase inhibitors (TKI) such as imatinib, nilotinib and dasatinib are now established as highly effective frontline therapies for chronic myeloid leukaemia (CML). Disease control is achieved in the majority of patients and survival is excellent such that recent focus has been on toxicities of these agents. Cumulative data have reported an excess of serious vascular complications, including arterial thrombosis and peripheral arterial occlusive disease, in patients receiving nilotinib in comparison with other TKIs, with resultant interest in delineating the pathophysiology and implications for rationale cardiovascular risk modification...
September 2016: Thrombosis Research
Priyanka Ramkrishna Rane, Rakesh K Barot, Devadatta Jayantilal Gohel, Nupur Bhagat
Chronic Myeloid Leukaemia (CML) causes retinopathy manifesting as venous dilation and tortuosity, perivascular sheathing, retinal haemorrhages, microaneurysms, cotton-wool spots and optic nerve infiltration. Retina is the most commonly involved intraocular structure in CML. However, retinal involvement is a rare form of presentation of CML and few cases have been reported. We report a case of CML presenting as unilateral sudden visual loss. Fundus showed multiple white centered retinal haemorrhages in both eyes with unilateral macular oedema...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Andrew M Brunner, Shuli Li, Amir T Fathi, Martha Wadleigh, Vincent T Ho, Kerry Collier, Christine Connolly, Karen K Ballen, Corey S Cutler, Bimalangshu R Dey, Areej El-Jawahri, Sarah Nikiforow, Steven L McAfee, John Koreth, Daniel J Deangelo, Edwin P Alyea, Joseph H Antin, Thomas R Spitzer, Richard M Stone, Robert J Soiffer, Yi-Bin Chen
We performed a retrospective study analysing the effect of sorafenib, an oral fms-Like Tyrosine Kinase 3 (FLT3)/multikinase inhibitor, as post-transplant maintenance in adult patients with FLT3-internal tandem duplication (ITD) acute myeloid leukaemia (AML). We identified consecutive patients with FLT3-ITD AML diagnosed between 2008 and 2014 who received haematopoietic cell transplantation (HCT) in first complete remission (CR1). Post-HCT initiation of sorafenib (yes/no) was evaluated as a time-varying covariate in the overall survival/progression-free survival (OS/PFS) analysis and we performed a landmark analysis of controls alive without relapse at the median date of sorafenib initiation...
July 19, 2016: British Journal of Haematology
Stina Söderlund, Torsten Dahlén, Fredrik Sandin, Ulla Olsson-Strömberg, Maria Creignou, Arta Dreimane, Anna Lübking, Berit Markevärn, Anders Själander, Hans Wadenvik, Leif Stenke, Johan Richter, Martin Höglund
OBJECTIVES: The primary goal in management of chronic phase (CP) chronic myeloid leukaemia (CML) is to prevent disease progression to accelerated phase (AP) or blast crisis (BC). We have evaluated progression rates in a decentralised healthcare setting and characterised patients progressing to AP/BC on TKI treatment. METHODS: Using data from the Swedish CML register, we identified CP-CML patients diagnosed 2007-2011 who progressed to AP/BC within 2 yrs from diagnosis (n = 18) as well as patients diagnosed in advanced phase during 2007-2012 (n = 36) from a total of 544 newly diagnosed CML cases...
July 18, 2016: European Journal of Haematology
B A Adeagbo, O O Bolaji, T A Olugbade, M A Durosinmi, R A Bolarinwa, C Masimirembwa
WHAT IS KNOWN AND OBJECTIVE: Imatinib mesylate is the first-line drug for the treatment of Philadelphia/bcr-abl positive chronic myeloid leukaemia (CML). It is known to be metabolized mostly by CYP3A4 and CYP3A5 isoforms while its efflux is mediated by the transporters ABCB1 and ABCG2. Genetic polymorphism of some of these enzymes and transporters have been linked with inter-individual variations in the pharmacokinetics of the drug. This study, therefore, investigated the influence of CYP3A5*3, ABCG2 421C>A and ABCB1 3435 C>T genetic polymorphism on the clinical outcome and steady-state trough plasma concentration (TPC) of imatinib in Nigerians with CML...
October 2016: Journal of Clinical Pharmacy and Therapeutics
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