Entropy – based Biomarkers for individualized response on Bosutinib treatment in chronic phase CML - Brummendorf

Despite the progress made in treatment options of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors (TKI), disease progression from the chronic phase (CP) towards an accelerated phase (AP) or blast crisis (BC) still poses a problem, as it can result in lower treatment success and elevated relapse rates. As a result, the prevention of disease progression remains the primary goal in treatment of CML patients and the prediction of progression risk is of high clinical relevance.

To date, the prognostication of CML is focused on clinical scores, such as Sokal, Hasford (“Hasford”) and semi-prospective monitoring of patients based on the kinetics of their clinical response and/or their minimal residual disease (MRD) state defined by the BCR-ABL mutation transcript levels at defined in time [3]. In order to complement this, prognostic or predictive biomarkers, such as the telomere length in leukemic cells or the proportion of BCR-ABL mutated cells in the patients’ immature CD34(+)38(-) stem cell compartment, are currently under investigation.

Despite their limitations, these scores can be used as valid prognostication tools, each fulfilling specific purposes. Still, they do not allow reliable inference of individual progression risk for clinical use yet, which is why we aim to apply a patient stratification method that combines clinical parameters with gene expression-related markers [1] to assess individual disease progression and make predictions about TKI efficacy in those patients.