ABSTRACT
Chronic myelogenous leukemia (CML), characterized by the BCR-ABL gene rearrangement, has been extensively studied. Significant progress has been made in the area of BCR-ABL-mediated intracellular signaling, which has led to a better understanding of BCR-ABL-mediated clinical features in chronic phase CML. Disease progression and blast crisis CML is associated with characteristic non-random cytogenetic and molecular events. These can be viewed as increased oncogenic activity or loss of tumor suppressor activity. However, what causes transformation and disease progression to blast crisis is only poorly understood. This is in part due to the lack of a good in vivo model of chronic phase CML even though animal models developed over the last few years have started to provide insights into blast crisis development. Thus, additional in vitro and in vivo studies will be needed to provide a complete understanding of the contribution of BCR-ABL and other genes to disease progression and to improve therapeutic approaches for blast crisis CML.
Subject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Animals , Apoptosis , Blast Crisis/genetics , Blast Crisis/pathology , Cell Differentiation , Chromosome Aberrations , DNA Repair , Disease Progression , Fusion Proteins, bcr-abl/genetics , Fusion Proteins, bcr-abl/physiology , Genes, Tumor Suppressor , Hematopoietic Stem Cells/pathology , Humans , Immunologic Surveillance , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology , Mice , Mice, Knockout , Models, Animal , Models, Biological , Neoplastic Stem Cells/pathology , Oncogenes , Signal TransductionABSTRACT
The BCR-ABL oncogene is essential to the pathogenesis of chronic myelogenous leukemia, and immune mechanisms play an important role in control of this disease. Understanding of the molecular pathogenesis of chronic myelogenous leukemia has led to the development of several novel therapies, which can be broadly divided into therapies based on 1) inhibition of the BCR-ABL oncogene expression, 2) inhibition of other genes important to the pathogenesis of chronic myelogenous leukemia, 3) inhibition of BCR-ABL protein function, and 4) immunomodulation. We have systematically reviewed each of these novel therapeutic approaches in this article.
