Prognostic significance of treatment response in CML in view of current recommendations for treatment and monitoring

The use of small-molecule kinase inhibitors has redefined the management of cancer. Chronic myelogenous leukaemia (CML) has become the paradigm for targeted cancer treatment. Imatinib has become the gold standard in the treatment of CML with excellent and durable responses and minimal side effects. Molecular diagnostics constitute an integral part of the routine monitoring. Results of cytogenetic analysis and quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) indicate suboptimal response or treatment failure and guide treatment. New Abl kinase inhibitors such as nilotinib or dasatinib are options after the failure of or intolerance to imatinib, and both are available for first-line treatment of newly diagnosed CML. This review focuses on the prognostic significance of achieving a response at specific time points in patients with CML treated with imatinib, nilotinib or dasatinib in view of available data and current treatment recommendations.