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Rationale for using arsenic trioxide ATO to eliminate LICs in CML. CML is driven by the Bcr-Abl oncoprotein that displays aberrant tyrosine kinase signaling. Tyrosine kinase inhibitors (TKI) such as imatinib can block aberrant signaling and prevent the formation of leukemic cells, but they do not eliminate LICs, thus requiring continuous treatment, inevitably resulting in resistance and relapse. ATO may synergize with TKI to eliminate LICs, thereby curing the disease.
