Implications of BCR-ABL1 kinase domain-mediated resistance in chronic myeloid leukemia

Leuk Res. 2014 Jan;38(1):10-20. doi: 10.1016/j.leukres.2013.09.011. Epub 2013 Sep 23.

Abstract

Patients with chronic myeloid leukemia develop resistance to both first-generation and second-generation tyrosine kinase inhibitors (TKIs) as a result of mutations in the kinase domain (KD) of BCR-ABL1. A wide range of BCR-ABL1 KD mutations that confer resistance to TKIs have been identified, and the T315I mutant has proven particularly difficult to target. This review summarizes the prevalence, impact, and prognostic implications of BCR-ABL1 KD mutations in patients with chronic myeloid leukemia who are treated with current TKIs and provides an overview of recent treatment guidelines and future trends for the detection of mutations.

Keywords: BCR-ABL1; Chronic myeloid leukemia; Kinase domain; Mutations; Philadelphia chromosome; Resistance; Tyrosine kinase inhibitors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • DNA Mutational Analysis / methods
  • DNA Mutational Analysis / trends
  • Drug Resistance, Neoplasm / genetics*
  • Forecasting
  • Fusion Proteins, bcr-abl / genetics*
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics*
  • Mutation*
  • Practice Guidelines as Topic
  • Prognosis
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • BCR-ABL1 fusion protein, human
  • Protein Kinase Inhibitors
  • Fusion Proteins, bcr-abl