How I treat CML blast crisis

Allogeneic hematopoietic SCT in combination with tyrosine kinase inhibitor treatment compared with TKI treatment alone in CML blast crisis

“…We have also presented the information split according to these definitions in the tables, and in this study, found that OS and EFS showed no statistical differences between the two definitions, although patients with 20-29% blasts would be expected to have a better overall prognosis. 30 The outcome of this study strongly supports the recommendation of the European Leukemia Net guidelines for CML-BC. 13,14 Improved outcomes from the combination treatment may be because pretreatment with TKIs reduced the leukemia burden before HSCT, and more importantly, the individualized TKI-based The median EFS in the TKIs+allo-HSCT group (18 months, 95% CI 1-72.7 months) was also significantly longer than that in the TKIs group (3 months; 95% CI 1.9-4.0 months).…”

Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy

“…Although CML is defined by the BCR-ABL1 gene fusion, 8 it frequently presents with other concurrent cytogenetic changes during disease progression. 5,9,10 Approximately 30% of cases in AP and 80% to 90% of cases in BP have ACAs. 9,11 Although previous studies have indicated that the major route ACAs 4,12-14 but not the minor route ACAs 12 are associated with poorer prognosis, these studies were often confounded by the concurrent The online version of this article contains a data supplement.…”

Spectrum of somatic mutation dynamics in chronic myeloid leukemia following tyrosine kinase inhibitor therapy

“…The survival of patients who progress to BP is comparable to the pre-TKI era, even with other salvage treatment modalities such as allogeneic stem cell transplantation. 5 Taking advantage of high-throughput technologies, extensive investigations into other myeloid malignancies have uncovered commonly mutated genes and their affected pathways. [6][7][8][9][10] The Cancer Genome Atlas (TCGA) Consortium has compiled a list of commonly mutated genes found in 199 of 200 adult de novo acute myeloid leukemia (AML) cases; these mutations were then classified into 8 categories based on the biological pathways they affect (activated signaling, chromatin modification, cohesion complex, DNA methylation, myeloid transcription factors, tumor suppressors, NPM1, and splicing machinery).…”