Clonal evolution in chronic myelogenous leukemia

Jorge Cortes, Michael E. O'Dwyer

Research output: Contribution to journalReview article

Abstract

Clonal evolution (CE) may be a marker of disease progression in chronic myelogenous leukemia (CML) and is thought to reflect the genetic instability of the highly proliferative CML progenitors. The frequency of CE increases with advancing stage, rising from 30% in accelerated phase and up to 80% in blast crisis. Given its association with disease progression, CE is considered a feature that defines accelerated-phase CML; however, not all studies have demonstrated a uniformly poor outcome for patients with CE. Chromosomal abnormalities in Ph chromosome negative metaphases increasingly have been recognized in patients treated with imatinib. The true incidence of this phenomenon is not clear but appears to occur in 2% to 17% of imatinib-treated patients. Regardless of the precise mechanism and the long-term clinical implications, the findings described in this article underscore the importance of routine cytogenetic analysis for patients treated with imatinib. The continued study of these phenomena will help us to understand better the pathogenesis of CML and improve the long-term treatment of patients with CML.

Original languageEnglish (US)
Pages (from-to)671-684
Number of pages14
JournalHematology/Oncology Clinics of North America
Volume18
Issue number3
DOIs
StatePublished - Jun 1 2004
Externally publishedYes

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Clonal Evolution
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Disease Progression
Leukemia, Myeloid, Chronic Phase
Blast Crisis
Cytogenetic Analysis
Metaphase
Chromosome Aberrations
Chromosomes
Incidence
Imatinib Mesylate

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Clonal evolution in chronic myelogenous leukemia. / Cortes, Jorge; O'Dwyer, Michael E.

In: Hematology/Oncology Clinics of North America, Vol. 18, No. 3, 01.06.2004, p. 671-684.

Research output: Contribution to journalReview article

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