Approximately half of patients are asymptomatic1 at diagnosis and have abnormalities in blood counts2
The 3 phases of CML are associated with decreasing survival
The leukemic clone increasingly loses the ability to differentiate as it progresses through the phases3
These images were originally published in ASH Image Bank. Maslak P. Normal peripheral blood smear-1. ASH Image Bank. 2008; image no. 00003666. CML-1. ASH Image Bank. 2008; 00001083. Accelerated Phase CML-2. ASH Image Bank. 2004; image no. 00002394. Blast Crisis of CML-4
- With the clinical application of tyrosine kinase inhibitors (TKIs) and careful disease monitoring in chronic myeloid leukemia (CML), the progression to advanced phase disease is uncommon, and the designation of an accelerated phase (AP) is not very relevant to disease deterioration. Therefore, the AP of CML is removed in the 5th WHO-Hem (World Health Organization Classification of Hematolymphoid Tumors) in order to emphasize other risk features related to TKI resistance.8
- Diagnostic criteria and treatment recommendations for CML-AP are still included in the NCCN Guidelines 20269
References
Aguayo A, Couban S. State-of-the-art in the management of chronic myelogenous leukemia in the era of the tyrosine kinase inhibitors: evolutionary trends in diagnosis, monitoring and treatment. Leukemia & lymphoma. 2009 Dec 1;50(sup2):1-8.
Vardiman JW. Chronic myelogenous leukemia, BCR-ABL1+. American journal of clinical pathology. 2009 Aug 1;132(2):250-60.
Druker BJ, Sawyers CL, Kantarjian H, Resta DJ, Reese SF, Ford JM, Capdeville R, Talpaz M. Activity of a specific inhibitor of the BCR-ABL tyrosine kinase in the blast crisis of chronic myeloid leukemia and acute lymphoblastic leukemia with the Philadelphia chromosome. New England Journal of Medicine. 2001 Apr 5;344(14):1038-42.
The American Cancer Society. Phases and Risk Scores for Chronic Myeloid Leukemia (CML). Available at: https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/detection-diagnosis-staging/staging.html . Last accessed 10/9/2025
Kantarjian H, O'Brien S, Jabbour E, Garcia-Manero G, Quintas-Cardama A, Shan J, Rios MB, Ravandi F, Faderl S, Kadia T, Borthakur G. Improved survival in chronic myeloid leukemia since the introduction of imatinib therapy: a single-institution historical experience. Blood, The Journal of the American Society of Hematology. 2012 Mar 1;119(9):1981-7.
Wang W, Cortes JE, Tang G, Khoury JD, Wang S, Bueso-Ramos CE, DiGiuseppe JA, Chen Z, Kantarjian HM, Medeiros LJ, Hu S. Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy. Blood, The Journal of the American Society of Hematology. 2016 Jun 2;127(22):2742-50.
Jain P, Kantarjian HM, Ghorab A, Sasaki K, Jabbour EJ, Nogueras Gonzalez G, Kanagal‐Shamanna R, Issa GC, Garcia‐Manero G, Kc D, Dellasala S. Prognostic factors and survival outcomes in patients with chronic myeloid leukemia in blast phase in the tyrosine kinase inhibitor era: cohort study of 477 patients. Cancer. 2017 Nov 15;123(22):4391-402.
Li W. The 5th edition of the World Health Organization classification of hematolymphoid tumors. Exon Publications. 2022 Oct 16:1-21.
National Comprehensive Cancer Network® (NCCN®), NCCN Guidelines Version 1.2026
Chronic Myeloid Leukemia. Available at: https://www.nccn.org/professionals/physician_gls/pdf/cml.pdf . Last accessed 10/9/2025
Approved by Egyptian Drug Authority: HF0424OA5944/042026. Invalidation date: 20/04/2028
Kindly report any violated online promotional, educational and awareness material not having this message to The General administration for Regulation of Marketing & Advertising Materials at: www.edaegypt.gov.eg
Image
HF0424OA5944/042026 20/04/2028 |