Management of chronic myeloid leukemia (CML): Blast Phase (BP)

Chronic myeloid leukemia blast phase (CML BP) continues to be the most challenging aspect of managing this CML. Unlike chronic phase where response rates (and possibly cure) seem to be promising; CML BP treatment is difficult due to worse performance status, different biology, increased frequency of ABL tyrosine kinase mutations and higher relapse rate. In adults, combination chemotherapy and tyrosine kinase inhibitors followed by allogenic hematopoietic stem cell transplant is the preferred plan for these patients. On the other hand, elderly patients with CML BP are often managed with single agent tyrosine kinase inhibitors (second generation or more) or combination with non-intensive chemotherapy for palliative approach.