Blast and accelerated phase CML: room for improvement.
Journal
Hematology. American Society of Hematology. Education Program
ISSN: 1520-4383
Titre abrégé: Hematology Am Soc Hematol Educ Program
Pays: United States
ID NLM: 100890099
Informations de publication
Date de publication:
10 12 2021
10 12 2021
Historique:
entrez:
10
12
2021
pubmed:
11
12
2021
medline:
19
2
2022
Statut:
ppublish
Résumé
Tyrosine kinase inhibitors (TKIs) revolutionized the treatment of chronic myeloid leukemia (CML). With TKI therapy, the percentage of patients who progress to accelerated phase (AP) or blast phase (BP) CML has decreased from more than 20% to 1% to 1.5% per year. Although AP- and BP-CML occur in a minority of patients, outcomes in these patients are significantly worse compared with chronic phase CML, with decreased response rates and duration of response to TKI. Despite this, TKIs have improved outcomes in advanced phase CML, particularly in de novo AP patients, but are often inadequate for lasting remissions. The goal of initial therapy in advanced CML is a return to a chronic phase followed by consideration for bone marrow transplantation. The addition of induction chemotherapy with TKI is often necessary for achievement of a second chronic phase. Given the small population of patients with advanced CML, development of novel treatment strategies and investigational agents is challenging, although clinical trial participation is encouraged in AP and BP patients, whenever possible. We review the overall management approach to advanced CML, including TKI selection, combination therapy, consideration of transplant, and novel agents.
Identifiants
pubmed: 34889372
pii: 482946
doi: 10.1182/hematology.2021000240
pmc: PMC8791122
doi:
Substances chimiques
Protein Kinase Inhibitors
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
122-128Informations de copyright
Copyright © 2021 by The American Society of Hematology.
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