Overview of the treatment of chronic myeloid leukemia
- Robert S Negrin, MD
Robert S Negrin, MD
- Section Editor — Bone Marrow Transplantation
- Professor of Medicine
- Stanford University School of Medicine
- Charles A Schiffer, MD
Charles A Schiffer, MD
- Professor of Medicine and Oncology
- Barbara Ann Karmanos Cancer Institute
- Wayne State University School of Medicine
Chronic myeloid leukemia (CML, chronic myelocytic or chronic myelogenous leukemia) is classified as a myeloproliferative disorder, along with polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (figure 1). (See "Overview of the myeloproliferative neoplasms".)
This group of diseases shares several distinct features:
●They are clonal disorders of hematopoiesis that arise in a hematopoietic stem or early progenitor cell.
●They are characterized by the dysregulated production of a particular lineage of mature myeloid cells with fairly normal differentiation.
●They exhibit a variable tendency to progress to acute leukemia.
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- DISEASE PHASE
- OVERVIEW OF TREATMENT OPTIONS
- Hematopoietic cell transplantation
- Tyrosine kinase inhibitors
- Other agents
- INITIAL TREATMENT
- Chronic phase
- Accelerated or blast phase
- MONITORING RESPONSE
- Schedule of evaluation
- Response criteria
- - Responses defined
- - Defining failure, suboptimal response, and optimal response
- Evaluation at loss of response
- DISCONTINUATION OF TKI THERAPY
- TREATMENT OF DISEASE RESISTANCE OR DRUG INTOLERANCE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS