A Discussion of Chronic Myeloid Leukemia

Abstract

Chronic Myeloid Leukemia (CML) is a triphasic hematological malignancy characterized by the presence of the abnormal Philadelphia chromosome, linked to causing uncontrolled myeloid cell proliferation in the bone marrow and marked changes in the peripheral blood and bone marrow microenvironments. The discovery of the BCR-ABL1 fusion oncogene from the balanced translocation of chromosomes 9 and 22, creating the Philadelphia chromosome, and its encoded tyrosine kinase protein has been linked to causing uncontrolled cell proliferation, leading to a subsequent development of tyrosine kinase inhibitors (TKI). TKIs, along with traditional chemotherapy drugs and interferon treatment, have revolutionized CML treatment, enabling deep remissions and prolonging of the disease’s chronic phase. This review will introduce CML and comprehensively explore the epidemiology, molecular basis, pathology, diagnostic approaches, and therapeutic strategies for CML, including their mechanisms of action and challenges, such as TKI resistance, with a focus on TKIs as the workhorses of CML therapy. By reviewing the current known literature, this paper aims to contribute to and guide the pursuit of new knowledge and research.