Kronisk myelogen leukemi (KML)
- Kronisk myelogen leukemi (KML)
- Bakgrunn
- Diagnose
- Prognose og risikofaktorer for sykdomsprogresjon
- Førstelinjebehandling i kronisk fase
- Håndtering og vurdering av kategoriene «Svikt» og «Advarsel»
- Fertilitet og amming
- Allogen stamcelletransplantasjon
- Behandling av blastfase
- Andre behandlingsregimer
- Seponering-Behandlingsfri remisjon (TFR)
Kronisk myelogen leukemi (KML)
Sist oppdatert: 17.04.2024
Mer informasjon
Utgiver: Helsedirektoratet
Versjon: 1.0
Tidligere versjoner
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Foreslå endringer/gi kommentarer
Endringer fra tidligere handlingsprogram:
- WHOs klassifisering fra 2022 innføres. Akselerert fase er avskaffet. I blastfase er grensen satt til 20% myeloblaster og >5% lymfoblaster i PB eller BM Dette betyr at resultater fra tidligere studier på blastfase og akselerert fase ikke nødvendigvis er fullt dekkende for pasienter som klassifiseres etter den nye definisjonen
- Start med Tyrosin kinase hemmer (TKI) på morfologisk sterk mistanke om kronisk myelogen leukemi (KML). Ikke bruk hydroxyurea eller allopurinol. Pasientene bør oppfordres til rikelig væskeinntak første måned.
- Imatinib og dasatinib foretrekkes i 1. linje av prishensyn, se Sykehusinnkjøp onkologiavtale
- Anbefalt startdose for dasatinib er redusert.
- Asciminib er innført av Nye metoder til behandling av Philadelphia- kromosom-positiv kronisk myelogen leukemi i kronisk fase (Ph+KML-KF) som tidligere er behandlet med to eller flere tyrosinkinasehemmere (TKIer), hvor rimeligere tyrosinkinasehemmere ikke er egnet.
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