Biomarkers for Determining the Prognosis of CML

Abstract

Tyrosine kinase inhibitors (TKIs) have dramatically improved the clinical outcome and prognosis for chronic myelogenous leukemia (CML) patients. However, some patients develop acquired resistance to TKI treatment. Several mechanisms for imatinib resistance in CML have been proposed, and "biomarkers" are used at diagnosis and during TKI treatment to predict CML patient outcome. In this chapter, we discuss prognostic scoring systems used at diagnosis such as the Sokal score, Hasford score, European Treatment and Outcome Study score, early molecular response to TKI as a surrogate endpoint, pharmacokinetic factors such as plasma concentration of TKIs, polymorphisms of drug transporters, immunological biomarkers such as T-cell profiling, and a common intronic deletion polymorphism in the gene-encoding BCL2-like 11 (BIM) as candidates for biomarkers associated with clinical endpoints.