Chronic myelogenous leukemia (CML) evolves from a chronic phase characterized by the Philadelphia chromosome as the sole genetic abnormality into blast crisis, which is often associated with additional chromosomal and molecular secondary changes. Blast crisis carries all the symptoms and characteristics of either acute myelogenous leukemia or acute lymphoblastic leukemia, and has a very high mortality rate. This stage can most effectively be treated by a bone marrow transplant after high-dose chemotherapy. In young patients in the accelerated phase, a transplant may also be an option. However the likelihood of relapse after a bone marrow transplant is higher in patients in blast crisis or in the accelerated phase as compared to patients in the chronic phase. Although imatinib and dasatinib are verye ffective in chronic phase CML, they much less effective in blast crisis, even at higher doses. Allogeneic stem cell transplantation remains the preferred option.
R. M. Stone Optimizing Treatment of Chronic Myeloid Leukemia: A Rational Approach
Oncologist, June 1, 2004; 9(3): 259 – 270.
Michael W.N. Deininger, Stephen G. O’Brien, John M. Ford, Brian J. Druker
Practical Management of Patients With Chronic Myeloid Leukemia Receiving Imatinib Journal of Clinical Oncology, Vol 21, Issue 8 (April), 2003: 1637-1647
Highlights of the 1st Annual NCCN Hematologic Malignancies Congress, published as a supplement to The Oncology Report by Elsevier Oncology. © 2006 NCCN.