[Evolution of BCR-ABL1 Testing for Chronic Myeloid Leukemia Under Tyrosine Kinase Inhibitor Treatment].

Hayato Miyachi
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Abstract

The advent and long-term use of tyrosine kinase inhibitors in molecular target therapy for chronic myeloid leukemia have resulted in a marked improvement of treatment outcomes. This has changed'the algorithm of the laboratory process for the diagnosis and therapeutic monitoring of chronic myeloid leukemia. It includes defining the molecular typing of BCR-ABL1 to establish the diagnosis, and a quantitative and/or high- sensitivity assay for minimal residual disease to evaluate the treatment response. Along with improved long-term survival outcomes, new issues have arisen regarding the best index to use for the improved clinical outcomes, such as treatment-free remission. To this end, clinical and laboratory monitoring of CML patients has been investigated. Novel methodologies and technologies have been applied to improve decision-making on patient care, tailoring the treatment to the individual characteristics of each patient, including an early index for the treatment response and deeper molecular response to realize treatment-free survival, and BCR-ABLI kinase domain mutation screening for refractory disease. In response to the advancement and applications of these emerging technologies, proper laboratory practice with the quality assurance of testing is expected. [Review].

[酪氨酸激酶抑制剂治疗下慢性髓系白血病BCR-ABL1检测的演变]。
酪氨酸激酶抑制剂在慢性髓性白血病分子靶向治疗中的出现和长期使用已经导致治疗结果的显着改善。这改变了慢性髓性白血病的诊断和治疗监测的实验室过程的算法。它包括确定BCR-ABL1的分子分型以确定诊断,以及对最小残留疾病进行定量和/或高灵敏度测定以评估治疗反应。随着长期生存结果的改善,新的问题出现了,关于用于改善临床结果的最佳指标,如无治疗缓解。为此,对CML患者的临床和实验室监测进行了调查。新的方法和技术已被应用于改善患者护理决策,根据每位患者的个体特征定制治疗,包括治疗反应的早期指数和更深层次的分子反应,以实现无治疗生存,以及难治性疾病的BCR-ABLI激酶结构域突变筛查。为了应对这些新兴技术的进步和应用,期望适当的实验室实践和测试的质量保证。(审查)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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