Sampaio MM, Santos MLC, Marques HS, Gonçalves VLS, Araújo GRL, Lopes LW, Apolonio JS, Silva CS, Santos LKS, Cuzzuol BR, Guimarães QES, Santos MN, de Brito BB, da Silva FAF, Oliveira MV, Souza CL, de Melo FF. Chronic myeloid leukemia-from the Philadelphia chromosome to specific target drugs: A literature review. World J Clin Oncol 2021; 12(2): 69-94 [PMID: 33680875 DOI: 10.5306/wjco.v12.i2.69]
Corresponding Author of This Article
Fabrício Freire de Melo, MSc, PhD, Postdoc, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremelo@yahoo.com.br
Research Domain of This Article
Oncology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Feb 24, 2021; 12(2): 69-94 Published online Feb 24, 2021. doi: 10.5306/wjco.v12.i2.69
Chronic myeloid leukemia-from the Philadelphia chromosome to specific target drugs: A literature review
Mariana Miranda Sampaio, Maria Luísa Cordeiro Santos, Hanna Santos Marques, Vinícius Lima de Souza Gonçalves, Glauber Rocha Lima Araújo, Luana Weber Lopes, Jonathan Santos Apolonio, Camilo Santana Silva, Luana Kauany de Sá Santos, Beatriz Rocha Cuzzuol, Quézia Estéfani Silva Guimarães, Mariana Novaes Santos, Breno Bittencourt de Brito, Filipe Antônio França da Silva, Márcio Vasconcelos Oliveira, Cláudio Lima Souza, Fabrício Freire de Melo
Mariana Miranda Sampaio, Maria Luísa Cordeiro Santos, Glauber Rocha Lima Araújo, Luana Weber Lopes, Jonathan Santos Apolonio, Camilo Santana Silva, Luana Kauany de Sá Santos, Beatriz Rocha Cuzzuol, Quézia Estéfani Silva Guimarães, Mariana Novaes Santos, Breno Bittencourt de Brito, Filipe Antônio França da Silva, Márcio Vasconcelos Oliveira, Cláudio Lima Souza, Fabrício Freire de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
Hanna Santos Marques, Vinícius Lima de Souza Gonçalves, Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45083-900, Bahia, Brazil
Author contributions: All authors contributed equally to this paper with conception and design of the study, literature review and analysis, drafting, critical revision, editing, and providing final approval of the version to be published.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabrício Freire de Melo, MSc, PhD, Postdoc, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremelo@yahoo.com.br
Received: August 11, 2020 Peer-review started: August 11, 2020 First decision: December 11, 2020 Revised: December 22, 2020 Accepted: January 28, 2021 Article in press: January 28, 2021 Published online: February 24, 2021 Processing time: 195 Days and 8.1 Hours
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly ― the presence of the Philadelphia chromosome. The advances in cytogenetic and molecular assays are of great importance to the diagnosis, prognosis, treatment, and monitoring of CML. The discovery of the breakpoint cluster region (BCR)-Abelson murine leukemia (ABL) 1 fusion oncogene has revolutionized the treatment of CML patients by allowing the development of targeted drugs that inhibit the tyrosine kinase activity of the BCR-ABL oncoprotein. Tyrosine kinase inhibitors (known as TKIs) are the standard therapy for CML and greatly increase the survival rates, despite adverse effects and the odds of residual disease after discontinuation of treatment. As therapeutic alternatives, the subsequent TKIs lead to faster and deeper molecular remissions; however, with the emergence of resistance to these drugs, immunotherapy appears as an alternative, which may have a cure potential in these patients. Against this background, this article aims at providing an overview on CML clinical management and a summary on the main targeted drugs available in that context.
Core Tip: Chronic myeloid leukemia is a clonal hematopoietic stem cell disorder with a well understood pathogenesis. In this sense, the research is directed towards new therapeutic alternatives and understanding of immunobiology, considering the growing resistance to standard therapy with tyrosine kinase inhibitors. This article aims to summarize the clinical approach and emerging therapeutic alternatives, considering the adverse effects of new drugs, transplants and immunotherapy.
