Chronic myeloid leukemia from pathophysiology to treatment-free remission: new perspectives

Grace Kelly Guevara Benítez; José Javier Camacho Dávalos; Luis Fernando Herrera Moscoso; Mayra Viviana Saa Álvarez; Rafael Elías Cabezas Cedeño; Luis Israel Aguas Infante

doi:10.18203/2320-6012.ijrms20253211

Authors

Grace Kelly Guevara Benítez Armed Forces Hospital Quito, Ecuador
José Javier Camacho Dávalos Armed Forces Hospital Quito, Ecuador
Luis Fernando Herrera Moscoso Armed Forces Hospital Quito, Ecuador
Mayra Viviana Saa Álvarez Armed Forces Hospital Quito, Ecuador
Rafael Elías Cabezas Cedeño Armed Forces Hospital Quito, Ecuador
Luis Israel Aguas Infante Armed Forces Hospital Quito, Ecuador

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253211

Keywords:

BCR-ABL1, Chronic myeloid leukemia, Hematology, Tyrosine kinase inhibitors, Treatment-free remission

Abstract

Chronic myeloid leukemia (CML) is one of the most common leukaemia’s occurring in the adult population. The course of CML is divided into three phases: the chronic phase, the acceleration phase and the blast phase. CML is a chronic myeloproliferative neoplasm characterized by the presence of the chimeric BCR-ABL1 gene, resulting from the chromosomal translocation t (9;22) (q34;q11), which encodes a constitutively active tyrosine kinase. The advent of tyrosine kinase inhibitors (TKIs) has revolutionized the management of CML, significantly improving patient survival and quality of life. Recent studies have shown that a subgroup of patients can maintain deep remission even after treatment discontinuation, a phenomenon known as treatment-free remission (TFR) . This narrative review synthesizes the current evidence on the pathophysiology of CML, therapeutic advances with TKIs and the clinical and prognostic criteria associated with TFR, providing an integrated view that can guide clinical practice and future research.

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