Chronic Myeloid Leukemia Coverage from Every Angle

Advances in Molecular Tools for Monitoring CML

By: Sarah Campen, PharmD
Posted: Friday, November 8, 2019

A review article published in the Frontiers in Oncology discussed the molecular tools available for the management of chronic myeloid leukemia (CML), focusing more on recent technical advances such as digital polymerase chain reaction (PCR) and next-generation sequencing (NGS). “The basis of successful management of CML patients will always be the strict collaboration between biologists, technicians, and physicians,” stated Barbara Izzo, PhD, of the University Federico II, Naples, Italy, and colleagues.

Currently, quantitative PCR is the standard technique used for the assessment of minimal residual disease in patients with CML treated with tyrosine kinase inhibitors. However, digital PCR appears to simplify the standardization process and improve the sensitivity and precision of quantitative measurements, according to recent published data. “Digital PCR seems to be a good, novel, sensitive, and accurate tool for molecular monitoring in CML; nevertheless, an international standardization is necessary before this technique enters routine molecular methods,” stated Dr. Izzo and colleagues.

Sanger sequencing has been the more commonly adopted method for evaluating mutations of the ABL1 kinase domain. Recently, NGS has emerged as a highly sensitive technique that is able to detect mutations at a subclonal level as well as compound mutations that are responsible for resistance to ponatinib. “NGS will likely be more frequently adopted for patients who fail the first line of therapy and for those who are in suboptimal response during further treatment lines,” explained the authors. For now, data produced with NGS in the allogeneic transplantation setting are not yet available; Sanger sequencing is still the recommended technique.

“Further harmonization of these molecular techniques by international projects is still necessary to speak a universal language,” concluded Dr. Izzo and colleagues. “The existing and future networks will help all of us to reach this goal.”

Disclosure: The study authors reported no conflicts of interest.

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