Treatment of Chronic Myeloid Leukemia in Blast Phase
Chronic myeloid leukemia in blast phase (CML-BP) is the most advanced stage of CML and requires prompt, intensive intervention. The treatment goal is to achieve a complete response, typically as a prerequisite for definitive therapy.
Clinical Scenario
CML can be classified into three phases: chronic phase (CP), accelerated phase (AP), and blast phase (BP). The blast phase is characterised by a predominance of immature blast cells and represents the highest-urgency disease stage, requiring a structured, evidence-based approach.
Treatment Approach
The approach for CML in blast phase combines chemotherapy — selected based on the disease's immunophenotype — with a targeted tyrosine kinase inhibitor, used as a bridge to allogeneic stem cell transplantation. The complete regimen, sequencing, and criteria are covered in the full structured protocol.
Treatment Goal
Achievement of a complete response.
References
DOI: 10.1002/ajh.27443CML can be classified into three phases: CP, accelerated phase (AP), and blast phase (BP).
At MD Anderson, patients with CML-BP are treated with a combination of chemotherapy (type depends on the immunophenotype) and ponatinib followed by allo-HSCT once a complete response is achieved, then given maintenance TKI therapy post-allo-HSCT.
TKIs combinations with chemotherapy should be used as a bridge to allo-HSCT.
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