Chronic myelogenous leukemia - Past, present, and future

Recent advances in the understanding of the molecular biology underlying CML, and in its therapy, have stimulated renewed interest in the entity. The early availability of oral single agents that provided effective disease control with minimal toxicity resulted in reluctance to explore new investigational approaches in the chronic phase, these being mostly applied in the blastic phase. However, the therapeutic success and cures obtained in acute leukemias, the invariably fatal outcome of CML, and the resistant nature of blast crisis to therapy, led to increased readiness to attempt different strategies in earlier stages. Such novel treatments have included intensive chemotherapy, interferons (IFNs), and bone marrow transplantation (BMT). Herein we review the biologic, clinical, and therapeutic aspects of the disease.