Upon completion of this CME activity, participants should be able to:

1.  Understand something of the origin of the BCR-ABL fusion gene, the signal transduction pathways involved in producing the clinical picture of chronic myeloid leukemia (CML) and the mechanisms of action of tyrosine kinase inhibitors.

2.  Have some insight into the possible mechanisms of genomic instability that predisposes to formation of the BCR-ABL fusion gene and predisposes also to disease progression.

3.  Define a leukemia stem cell and its relationship to disease kinetics in so far as current knowledge permits.

4.  Discuss the role of the microenvironment and epigenetic mechanisms in the genesis and progression of CML.

5.  Evaluate the merits of various management decisions, eg., how to start treatment for patients in the different phases of CML, how to assess success or failure of initial treatment, what approaches to consider for patients who have failed to respond well to initial treatment, including assessing the precise role of second generation TKIs and other non-molecular therapeutic approaches.

6.  Review new modalities of monitoring and mutation assessment and update the current understanding of proper monitoring, clinical significance of monitoring results at different time points, and the importance of timely assessments in the proper management of CML.

7.  Assess the role of allogeneic stem cell transplantation in the management of CML in 2018.

8.  Critically evaluate the current understanding of treatment discontinuation and approaches to improve the eligibility and outcome for treatment discontinuation.

9. Review current understanding of mechanisms of resistance to tyrosine kinase inhibitors and ways to overcome it.