OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press74810.17650/1818-8346-2008-0-4-17-25HEMATOLOGIC MALIGNANCIES: TREATMENT, SUPPORTIVE CAREГЕМОБЛАСТОЗЫ: ЛЕЧЕНИЕ, СОПРОВОДИТЕЛЬНАЯ ТЕРАПИЯMolecular genetics monitoring of tyrosine kinase inhibitor therapy for chronic myeloid leukemiaМолекулярно-генетический мониторинг терапии хронического миелолейкоза ингибиторами тирозинкиназKutsevS. I.КуцевС. И.
Russian Federation

Rostov-on-Don

Ростов-на-Дону

VelchenkoM. V.ВельченкоМ. В.
Russian Federation

Rostov-on-Don

Ростов-на-Дону

ZelzerA. N.ЗельцерА. Н.
Russian Federation

Rostov-on-Don

Ростов-на-Дону

Rostov State Medical UniversityГОУ ВПО Ростовский государственный медицинский университет251120084172525112022251120222008https://oncohematology.abvpress.ru/ongm/article/view/748

Therapy for Ph-positive chronic myeloid leukemia (CML) with the tyrosine kinase inhibitor imatinib results in achievement of high hematological and cytogenetic response rates. However, most patients with a complete cytogenetic response were found to have a minimal residual disease. Therefore the role of molecular monitoring during CML therapy has recently increased. Regular molecular monitoring allows to early diagnosis of relapse and improvement of treatment outcome as a result of therapeutic intervention. For the imatinib-treated patients therapy resistance or increased BCR-ABL gene expression is an indication for kinase domain mutations testing. Detection of the mutations causing imatinib resistance is required for therapy choice. Real-time polymerase chain reaction and DNA sequencing should become customary for CML monitoring.

Терапия Ph-позитивного хронического миелолейкоза (ХМЛ) игибитором тирозинкиназ иматинибом приводит к достижению гематологической и цитогенетической ремиссии с большой частотой. Однако у большинства пациентов с полным цитогенетическим ответом молекулярными методами обнаруживается минимальная остаточная болезнь. В связи с этим роль молекулярного мониторинга терапии ХМЛ в последние годы возросла. Регулярный молекулярный мониторинг позволяет рано выявить рецидив и, как следствие терапевтической интервенции, улучшить результаты лечения. Для пациентов с ХМЛ, получающих лечение иматинибом, резистентность к проводимой терапии или повышение уровня экспрессии гена BCR-ABL служат показанием для анализа мутаций киназного домена этого гена. Выявление мутаций, ставших причиной резистентности к иматинибу, необходимо для выбора тактики терапии. Молекулярные методы полимеразной цепной реакции в режиме реального времени и ДНК-секвенирования должны войти в практику мониторинга ХМЛ.

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