Impact De Dosage Quantitatif De Bcr:abl Dans Le Suivi Des LMC

Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm characterized by the Philadelphia chromosome (Ph), arising from the reciprocal translocation t(9;22)(q34;q11.2), which generates the BCR-ABL1 fusion gene encoding a constitutively active tyrosine kinase. This oncoprotein aberrantly activates RAS/MAPK, PI3K/AKT and JAK/STAT5 signaling pathways, driving uncontrolled proliferation, apoptosis resistance and genomic instability. The development of tyrosine kinase inhibitors (TKIs) — imatinib, dasatinib, nilotinib, bosutinib and ponatinib — has dramatically improved patient outcomes, with life expectancy now approaching that of the general population. Therapeutic monitoring relies on standardized BCR-ABL1 transcript quantification by RT-qPCR on the International Scale (IS), enabling assessment of hematologic, cytogenetic and molecular responses (MMR, MR4, MR4.5) according to ELN 2020 guidelines. Digital PCR (dPCR) is an emerging complementary technology providing absolute quantification with superior sensitivity for deep residual disease monitoring. This bibliographic review offers a comprehensive synthesis of current knowledge, with particular emphasis on the epidemiological and clinical specificities of CML in the Algerian context.