Chronic myeloid leukemia (CML)
Transplant advances and outcomes
Approximately 8,900 individuals in the United States are diagnosed with chronic myeloid leukemia (CML) each year. This myeloproliferative neoplasm primarily affects older adults, with a median age at diagnosis of 65 years. Approximately 2% of patients diagnosed with CML are under the age of 20. [1]
Allogeneic hematopoietic cell transplantation (HCT) is no longer considered first-line treatment for adults with CML due to evidence of significant clinical benefit for patients receiving BCR-ABL1 tyrosine kinase inhibitors (TKIs).
Recommended timing for transplant consultation
Inadequate hematologic or cytogenetic/molecular response to tyrosine kinase inhibitor (TKI) therapies
- Disease progression
- Intolerance to TKI therapies
- Accelerated phase
- Blast crisis (myeloid or lymphoid)
- T315I mutation
References
- SEER Stat Fact Sheets: Chronic Myeloid Leukemia. Website accessed 2 November, 2017. Access
- NMDP and ASTCT Recommended Timing for Transplant Consultation. Download PDF
- Warlick E, Ahn KW, Pedersen TL, et al. Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era. Blood. 2012; 119(17): 4083-4090. Access
- Jabbour E, Cortes J, Santos FPS, et al. Results of allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia patients who failed tyrosine kinase inhibitors after developing BCR-ABL1 kinase domain mutations. Blood. 2011; 117(13): 3641-3647. Access
- Velev N, Cortes J, Champlin R, et al. Stem cell transplantation for patients with chronic myeloid leukemia resistant to tyrosine kinase inhibitors with BCR-ABL kinase domain mutation T315I. Cancer. 2010; 116(15): 3631-3637. Access
- National Comprehensive Cancer Network. Chronic Myeloid Leukemia. (Version 1.2023). Access