Chronic Myeloid Leukemia (CML)
Approximately 8,900 individuals are diagnosed with chronic myeloid leukemia (CML) each year in the United States. This myeloproliferative neoplasm primarily affects older adults, with a median age at diagnosis of 64 years. Approximately 2% of patients diagnosed with CML are under age 20. [1]
Following evidence of significant clinical benefit for CML patients receiving BCR-ABL1 tyrosine kinase inhibitors (TKIs), the use of allogeneic hematopoietic cell transplantation (HCT) for adults with CML is no longer considered first line treatment.
Allogeneic HCT is now indicated for patients with CML who have inadequate hematologic or cytogenetic response, or whose disease develops resistance to TKI treatment or who are intolerant to TKIs, and remains the only curative option. [2]
Advances
Recent research in CML provides new data for clinical decision-making:
Outcomes
Review outcomes for allogeneic transplantation in patients with CML below. View additional CML slides showing demographic data and transplant trends.
Data in this section have been prepared by CIBMTR® (Center for International Blood and Marrow Transplant Research), our research program.
Figure 1. CML Survival Over Time, Unrelated HCT
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Figure 2. CML Survival, Unrelated Marrow HCT, by Disease Status
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Figure 3. CML Survival, Unrelated PBSC HCT, by Disease Status
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Figure 4. CML Survival, Sibling HCT, by Disease Status
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Referral Timing Guidelines
These guidelines highlight disease categories that include patients at risk for disease progression and who should be referred for a consultation for autologous or allogeneic transplantation. [2]
Transplant Consultation Guidelines: CML
- Inadequate hematologic or cytogenetic response to tyrosine kinase inhibitor (TKI) therapies
- Disease progression
- Intolerance to TKI therapies
- Accelerated phase
- Blast crisis (myeloid or lymphoid)
Download as a slide (PPT)
View complete Referral Timing Guidelines
References
- SEER Stat Fact Sheets: Chronic Myeloid Leukemia. Website accessed 2 November, 2017. Access
- NMDP/Be The Match and ASBMT Recommended Timing for Transplant Consultation, 2018. 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