Materiały źródłowe

• #1 Targeted Therapy Drugs for Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/targeted-therapies.html

  Chronic myeloid leukemia (CML) cells contain an abnormal gene, BCR-ABL, that isn’t found in normal cells. This gene makes a protein, BCR-ABL, which causes CML cells to grow and reproduce out of control. BCR-ABL is a type of protein known as a tyrosine kinase. […] Drugs known as tyrosine kinase inhibitors (TKIs) that target BCR-ABL are the most common treatment for CML. […] TKIs that can be used to treat CML include: Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), Ponatinib (Iclusig), Asciminib (Scemblix). […] These drugs seem to work best when CML is in the chronic phase, but some can also help people with more advanced disease (accelerated or blast phases). […] In most people, the TKIs don’t seem to make the leukemia go away forever, so these drugs need to be taken indefinitely.

• #2 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422

  The goal of chronic myelogenous leukemia treatment is to eliminate the blood cells that contain the BCR-ABL gene. For most people, treatment begins with targeted therapy that may help achieve a long-term remission of the disease. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted therapy can cause cancer cells to die. In chronic myelogenous leukemia, the target of these medicines is the tyrosine kinase protein produced by the BCR-ABL gene. The medicines are called tyrosine kinase inhibitors, also known as TKIs. […] TKIs are the initial treatment for people diagnosed with chronic myelogenous leukemia. Side effects of these targeted medicines include swelling or puffiness of the skin, nausea, muscle cramps, fatigue, diarrhea, and skin rashes.

• #3 Chronic Myeloid Leukemia (CML) | Learn What Is CML | LLS

  https://www.lls.org/leukemia/chronic-myeloid-leukemia

  Chronic myeloid leukemia (CML) is usually diagnosed in its chronic phase when treatment is very effective for most patients. […] Most CML patients are treated with daily oral drug therapy. […] Since the introduction of tyrosine kinase inhibitor (TKI) therapy in 2001, CML has been transformed from a life-threatening disease to a manageable chronic condition for most patients. People are living longer with CML and experiencing fewer treatment side effects.

• #4 Chronic myelogenous leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_myelogenous_leukemia

  Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia, is a cancer of the white blood cells. CML is largely treated with targeted drugs called tyrosine-kinase inhibitors (TKIs) which have led to dramatically improved long-term survival rates since 2001. These drugs have revolutionized treatment of this disease and allow most patients to have a good quality of life when compared to the former chemotherapy drugs. The only curative treatment for CML is a bone marrow transplant or an allogeneic stem cell transplant. Other than this there are four major mainstays of treatment in CML: treatment with tyrosine kinase inhibitors, myelosuppressive or leukapheresis therapy (to counteract the leukocytosis during early treatment), splenectomy and interferon alfa-2b treatment. In the past, antimetabolites (e.g., cytarabine, hydroxyurea), alkylating agents, interferon alfa 2b, and steroids were used as treatments of CML in the chronic phase, but since the 2000s have been replaced by Bcr-Abl tyrosine-kinase inhibitors drugs that specifically target BCR-ABL, the constitutively activated tyrosine kinase fusion protein caused by the Philadelphia chromosome translocation. The first of this new class of drugs was imatinib mesylate (marketed as Gleevec or Glivec), approved by the US Food and Drug Administration (FDA) in 2001. To overcome imatinib resistance and to increase responsiveness to TK inhibitors, four novel agents were later developed. Asciminib (Scemblix) was approved for medical use in the United States in October 2021. While capable of producing significantly improved responses compared with the action of imatinib, neither dasatinib nor nilotinib could overcome drug resistance caused by one particular mutation found to occur in the structure of BCR-ABL1 known as the T315I mutation. In October 2021, the Food and Drug Administration approved asciminib (Scemblix), the first TK inhibitor specifically targeting the ABL1 myristoyl pocket (STAMP) via allosteric binding, as a third-line option for patients with chronic-phase-CML.

• #5 Chronic Myeloid Leukemia (CML) | Treatment by Phase of CML | LLS

  https://www.lls.org/leukemia/chronic-myeloid-leukemia/treatment

  It’s important that your doctor is experienced in treating patients with chronic myeloid leukemia (CML) or has access to a CML specialist. Doctors who specialize in treating patients with CML are called hematologist-oncologists. […] Tyrosine kinase inhibitor (TKI) therapy is standard treatment for chronic phase CML. TKIs are often successful at managing CML for long periods of time. The following TKIs are approved as primary treatment for chronic phase CML: Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), Asciminib (Scemblix). […] The goal in treating accelerated phase CML, just as with the chronic phase, is to eliminate all cells that contain the BCR::ABL1 gene, leading to a remission. […] Treatment options for accelerated phase CML depend on the patients previous treatments. If CML is diagnosed in the accelerated phase and the patient has not yet tried a TKI, one treatment option is to begin TKI therapy.

• #6 Treatment options for chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/treatment/treatment-decisions

  A team of health professionals decides what treatment options you have. The most common treatments for chronic myeloid leukaemia (CML) are targeted cancer drugs. These drugs are called tyrosine kinase inhibitors (TKIs). […] The main treatment for CML are targeted cancer drugs. Other possible treatments include chemotherapy and a stem cell transplant. […] Targeted cancer drugs can change the way that cells work and help the body control the growth of cancer. There are different types of targeted cancer drugs. The main type for CML are: tyrosine kinase inhibitors (TKIs). […] Examples of TKI drugs for CML are imatinib, bosutinib, dasatinib and nilotinib. […] Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream. Fludarabine, idarubicin and cytarabine are examples of chemotherapy drugs for CML.

• #7 Targeted Therapy Drugs for Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/targeted-therapies.html

  Chronic myeloid leukemia (CML) cells contain an abnormal gene, BCR-ABL, that isn’t found in normal cells. This gene makes a protein, BCR-ABL, which causes CML cells to grow and reproduce out of control. BCR-ABL is a type of protein known as a tyrosine kinase. […] Drugs known as tyrosine kinase inhibitors (TKIs) that target BCR-ABL are the most common treatment for CML. […] TKIs that can be used to treat CML include: Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), Ponatinib (Iclusig), Asciminib (Scemblix). […] These drugs seem to work best when CML is in the chronic phase, but some can also help people with more advanced disease (accelerated or blast phases). […] In most people, the TKIs don’t seem to make the leukemia go away forever, so these drugs need to be taken indefinitely.

• #8 Targeted Therapy Drugs for Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/targeted-therapies.html

  Imatinib (Gleevec) was the first drug to specifically target the BCR-ABL tyrosine kinase protein, and its sometimes the first drug tried in a person with CML. […] Most people with CML respond to treatment with imatinib, and these responses often last for many years. […] Dasatinib (Sprycel) is another TKI that targets the BCR-ABL protein. […] Nilotinib (Tasigna) is another TKI that targets the BCR-ABL protein. […] Bosutinib (Bosulif) is another TKI that targets the BCR-ABL protein. […] Ponatinib (Iclusig) is a TKI targeting the BCR-ABL protein. […] Asciminib (Scemblix) targets a different part of the BCR-ABL protein than the other TKIs. […] This drug can be used as the first treatment for chronic phase CML, or it can be used if other TKIs have already been tried or if the leukemia cells have a gene change called the T315I mutation.

• #9 Targeted Therapy Drugs for Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating/targeted-therapies.html

  Chronic myeloid leukemia (CML) cells contain an abnormal gene, BCR-ABL, that isn’t found in normal cells. This gene makes a protein, BCR-ABL, which causes CML cells to grow and reproduce out of control. BCR-ABL is a type of protein known as a tyrosine kinase. […] Drugs known as tyrosine kinase inhibitors (TKIs) that target BCR-ABL are the most common treatment for CML. […] TKIs that can be used to treat CML include: Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), Ponatinib (Iclusig), Asciminib (Scemblix). […] These drugs seem to work best when CML is in the chronic phase, but some can also help people with more advanced disease (accelerated or blast phases). […] In most people, the TKIs don’t seem to make the leukemia go away forever, so these drugs need to be taken indefinitely.

• #10 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  With the improving knowledge of CML and its management, the goals of therapy need to be revisited to ensure an optimal use of the BCR::ABL1 TKIs in the frontline and later-line therapy of CML. […] In the frontline therapy of CML in the chronic phase (CML-CP), imatinib and the three second-generation TKIs (bosutinib, dasatinib and nilotinib) are associated with comparable survival results. […] The choice of the second-generation TKI versus imatinib in frontline therapy is based on the treatment aims (survival, TFR), the CML risk, the drug cost, and the toxicity profile with respect to the patients comorbidities. […] The TKI dosing is more flexible than has been described in the registration trials, and dose adjustments can be considered both in the frontline and later-line settings (e.g., dasatinib 50mg frontline therapy; dose adjusted schedules of bosutinib and ponatinib), as well as during an ongoing TKI therapy to manage toxicities, before considering changing the TKI.

• #11 Chronic Myelogenous Leukemia (CML) Treatment & Management: Approach Considerations, Imatinib, Newer Tyrosine Kinase Inhibitors

  https://emedicine.medscape.com/article/199425-treatment

  The goals of treatment of chronic myelogenous leukemia (CML) are threefold and have changed markedly since the advent of tyrosine kinase inhibitor (TKI) therapy. They are as follows: […] The standard treatment of choice for chronic phase CML is a TKI: either the first-generation TKI imatinib, which is a specific small-molecule inhibitor of BCR-ABL in all phases of CML, or a second-generation TKIs nilotinib (Tasigna), dasatinib (Sprycel), or bosutinib (Bosulif). […] In patients with a durable deep molecular response to TKI therapy, treatment discontinuation may be considered. […] Some patients with CML progress to a transitional or accelerated phase, which may last for several months. […] Many of the treatment decisions in CML, including possible hematopoietic stem cell transplantation and investigative options for younger patients, are extremely complex and in constant flux.

• #12 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  Four BCR::ABL1 TKIs are approved for frontline therapy: imatinib, dasatinib, bosutinib and nilotinib. […] The choice of frontline therapy may depend on additional factors: Aim of therapy (survival or TFR): Among older patients, survival may be the primary aim, and TFR secondary. […] In younger patients, TFR may be pursued more aggressively by some CML experts and patients, with changes in therapy in the absence of a DMR. […] In the German CML IV trial of 1551 patients treated in chronic phase (CP) with imatinib-based regimens, with a median follow-up time of 10 years, the 10-year OS rate was 82%, the relative survival rate 92%, and the cumulative incidence of blast phase (BP) only 5.8%. […] Thus, frontline therapy with the existing TKIs achieves the primary endpoint of survival normalization for most patients with CML.

• #13 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  Four BCR::ABL1 TKIs are approved for frontline therapy: imatinib, dasatinib, bosutinib and nilotinib. […] The choice of frontline therapy may depend on additional factors: Aim of therapy (survival or TFR): Among older patients, survival may be the primary aim, and TFR secondary. […] In younger patients, TFR may be pursued more aggressively by some CML experts and patients, with changes in therapy in the absence of a DMR. […] In the German CML IV trial of 1551 patients treated in chronic phase (CP) with imatinib-based regimens, with a median follow-up time of 10 years, the 10-year OS rate was 82%, the relative survival rate 92%, and the cumulative incidence of blast phase (BP) only 5.8%. […] Thus, frontline therapy with the existing TKIs achieves the primary endpoint of survival normalization for most patients with CML.

• #14 Chronic myeloid leukemia: 2025 update on diagnosis, therapy, and monitoring – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39093014/

  Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with an annual incidence of two cases/100 000. It accounts for approximately 15% of newly diagnosed cases of leukemia in adults. […] Four tyrosine kinase inhibitors (TKIs), imatinib, dasatinib, bosutinib, and nilotinib, are approved by the United States Food and Drug Administration (FDA) for first-line treatment of newly diagnosed CML in the chronic phase (CML-CP). Clinical trials with second and third-generation TKIs in frontline CML-CP therapy reported significantly deeper and faster responses but had no impact on survival prolongation, likely because of their potent efficacy and the availability of effective TKIs salvage therapies for patients who have a cytogenetic relapse with frontline TKI therapy. All four TKIs are equivalent if the aim of therapy is to improve survival. In younger patients with high-risk disease and in whom the aim of therapy is to induce a treatment-free remission status, second-generation TKIs may be favored.

• #15 Chronic Myeloid Leukemia (CML) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myeloid-leukemia-cml

  The response to TKI therapy is the most important prognostic factor for patients with CML. […] Rarely, other drugs are used as palliation in CML. These drugs include hydroxyurea, busulfan, and recombinant interferon or pegylated interferon. […] Allogeneic stem cell transplantation, because of its toxicity and because of the efficacy of tyrosine kinase inhibitors, is used selectively. Transplantation is reserved for patients with accelerated- or blast-phase CML resistant to BCR-ABL inhibitors. Transplantation can be curative. […] Tyrosine kinase inhibitors are extremely effective, prolong survival, and may even be curative. […] Stem cell transplantation can be curative and may help patients who do not respond to tyrosine kinase inhibitors or who progress to accelerated or blast phase.

• #16 Chronic Myeloid Leukemia (CML) in Children and Teens – Together by St. Jude™

  https://together.stjude.org/en-us/conditions/cancers/chronic-myeloid-leukemia-cml.html

  Drugs called tyrosine kinase inhibitors (TKIs) are the first line of treatment. They target tyrosine kinase enzymes, which cause leukemia cells to grow and divide quickly. […] First-line treatment for CML is usually the drug imatinib (Gleevec). This drug is a type of targeted therapy known as tyrosine kinase inhibitor (TKI). Tyrosine kinase is a property of certain enzymes made by the body. The tyrosine kinase activity can become too high in cancer, causing cancer cells to grow. Imatinib blocks the tyrosine kinase activity and helps stop the growth of cancer cells. […] Other TKI drugs called dasatinib, nilotinib, and ponatinib are sometimes used if patients cannot tolerate imatinib. These drugs are sometimes called 2nd generation TKIs. […] During treatment, doctors closely watch how patients respond to therapy. This is called monitoring. Monitoring may include a health history, physical exam, complete blood count, and molecular testing.

• #17 Chronic Myeloid Leukemia (CML) in Children and Teens – Together by St. Jude™

  https://together.stjude.org/en-us/conditions/cancers/chronic-myeloid-leukemia-cml.html

  Molecular testing can measure the number of leukemia cells in blood. It can find 1 leukemia cell among 10,000-100,000 normal cells. Molecular tests occur every 3-6 months after the start of therapy. […] A stem cell transplant (also known as bone marrow transplant or hematopoietic cell transplant) is another treatment option for CML. […] A transplant can cure CML. But the patient must have a suitable cell donor.

• #18 European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia | Leukemia

  https://www.nature.com/articles/s41375-020-0776-2

  The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

• #19 European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia | Leukemia

  https://www.nature.com/articles/s41375-020-0776-2

  The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

• #20 Chronic myeloid leukemia: 2025 update on diagnosis, therapy, and monitoring – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39093014/

  For CML post-failure on frontline therapy, second-line options include second and third-generation TKIs. Although potent and selective, these TKIs exhibit unique pharmacological profiles and response patterns relative to different patient and disease characteristics, such as patients’ comorbidities and financial status, disease stage, and BCR::ABL1 mutational status. Patients who develop the T315I „gatekeeper” mutation display resistance to all currently available TKIs except ponatinib, asciminib, and olverembatinib. Allogeneic stem cell transplantation remains an important therapeutic option for patients with CML-CP and failure (due to resistance) of at least two TKIs and for all patients in advanced-phase disease. Older patients who have a cytogenetic relapse post-failure on all TKIs can maintain long-term survival if they continue a daily most effective/least toxic TKI, with or without the addition of non-TKI anti-CML agents (hydroxyurea, omacetaxine, azacitidine, decitabine, cytarabine, and others).

• #21 Targeted cancer drugs for chronic myeloid leukaemia | Chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/treatment/targeted-drugs

  The most common treatment for chronic myeloid leukaemia (CML) is a type of targeted cancer drug called a tyrosine kinase inhibitor (TKI). […] Common TKIs for CML include imatinib, bosutinib, dasatinib and nilotinib. […] Most people take a TKI as their first treatment for CML. You usually take the TKI drug on its own, as your main treatment. […] The most common first TKI drug for CML is: imatinib (Glivec). […] There are other types of TKI you might have as your first treatment. These include: dasatinib (Sprycel), nilotinib (Tasigna). […] The next treatment you have depends on what TKI you have taken already. Some of the common next treatments for CML are: dasatinib (Sprycel), nilotinib (Tasigna), bosutinib (Bosulif), ponatinib (Iclusig), asciminib (Scemblix). […] You might take a TKI drug alongside chemotherapy, if you have blast phase CML.

• #22 Targeted cancer drugs for chronic myeloid leukaemia | Chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/treatment/targeted-drugs

  The most common treatment for chronic myeloid leukaemia (CML) is a type of targeted cancer drug called a tyrosine kinase inhibitor (TKI). […] Common TKIs for CML include imatinib, bosutinib, dasatinib and nilotinib. […] Most people take a TKI as their first treatment for CML. You usually take the TKI drug on its own, as your main treatment. […] The most common first TKI drug for CML is: imatinib (Glivec). […] There are other types of TKI you might have as your first treatment. These include: dasatinib (Sprycel), nilotinib (Tasigna). […] The next treatment you have depends on what TKI you have taken already. Some of the common next treatments for CML are: dasatinib (Sprycel), nilotinib (Tasigna), bosutinib (Bosulif), ponatinib (Iclusig), asciminib (Scemblix). […] You might take a TKI drug alongside chemotherapy, if you have blast phase CML.

• #23 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  For patients with true resistance to second-generation TKIs or with the T315I gatekeeper mutation, the third-generation TKIs are preferred. […] Ponatinib should be considered first because of the cumulative experience and results in the CML subsets, including in T315I-mutated CML. […] Asciminib is a third-generation TKI with possibly a better toxicity profile, but lesser activity in T315I-mutated CML. […] Olverembatinib is another potent third-generation TKI with early promising results. […] The primary aim of CML therapy is to improve survival so that it matches that of a normal population. […] A second aim, emphasized in the past decade but that benefits fewer patients, is the achievement of a durable deep molecular response (DMR), which can then allow treatment discontinuation and potentially a treatment-free remission (TFR) status.

• #24 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  For patients with true resistance to second-generation TKIs or with the T315I gatekeeper mutation, the third-generation TKIs are preferred. […] Ponatinib should be considered first because of the cumulative experience and results in the CML subsets, including in T315I-mutated CML. […] Asciminib is a third-generation TKI with possibly a better toxicity profile, but lesser activity in T315I-mutated CML. […] Olverembatinib is another potent third-generation TKI with early promising results. […] The primary aim of CML therapy is to improve survival so that it matches that of a normal population. […] A second aim, emphasized in the past decade but that benefits fewer patients, is the achievement of a durable deep molecular response (DMR), which can then allow treatment discontinuation and potentially a treatment-free remission (TFR) status.

• #25 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  For patients with true resistance to second-generation TKIs or with the T315I gatekeeper mutation, the third-generation TKIs are preferred. […] Ponatinib should be considered first because of the cumulative experience and results in the CML subsets, including in T315I-mutated CML. […] Asciminib is a third-generation TKI with possibly a better toxicity profile, but lesser activity in T315I-mutated CML. […] Olverembatinib is another potent third-generation TKI with early promising results. […] The primary aim of CML therapy is to improve survival so that it matches that of a normal population. […] A second aim, emphasized in the past decade but that benefits fewer patients, is the achievement of a durable deep molecular response (DMR), which can then allow treatment discontinuation and potentially a treatment-free remission (TFR) status.

• #26 Chronic myelogenous leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Chronic_myelogenous_leukemia

  Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia, is a cancer of the white blood cells. CML is largely treated with targeted drugs called tyrosine-kinase inhibitors (TKIs) which have led to dramatically improved long-term survival rates since 2001. These drugs have revolutionized treatment of this disease and allow most patients to have a good quality of life when compared to the former chemotherapy drugs. The only curative treatment for CML is a bone marrow transplant or an allogeneic stem cell transplant. Other than this there are four major mainstays of treatment in CML: treatment with tyrosine kinase inhibitors, myelosuppressive or leukapheresis therapy (to counteract the leukocytosis during early treatment), splenectomy and interferon alfa-2b treatment. In the past, antimetabolites (e.g., cytarabine, hydroxyurea), alkylating agents, interferon alfa 2b, and steroids were used as treatments of CML in the chronic phase, but since the 2000s have been replaced by Bcr-Abl tyrosine-kinase inhibitors drugs that specifically target BCR-ABL, the constitutively activated tyrosine kinase fusion protein caused by the Philadelphia chromosome translocation. The first of this new class of drugs was imatinib mesylate (marketed as Gleevec or Glivec), approved by the US Food and Drug Administration (FDA) in 2001. To overcome imatinib resistance and to increase responsiveness to TK inhibitors, four novel agents were later developed. Asciminib (Scemblix) was approved for medical use in the United States in October 2021. While capable of producing significantly improved responses compared with the action of imatinib, neither dasatinib nor nilotinib could overcome drug resistance caused by one particular mutation found to occur in the structure of BCR-ABL1 known as the T315I mutation. In October 2021, the Food and Drug Administration approved asciminib (Scemblix), the first TK inhibitor specifically targeting the ABL1 myristoyl pocket (STAMP) via allosteric binding, as a third-line option for patients with chronic-phase-CML.

• #27 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422

  A bone marrow transplant, also called a stem cell transplant, is the only treatment that can cure chronic myelogenous leukemia. However, it’s usually reserved for people who haven’t been helped by other treatments. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy medicines are sometimes combined with targeted therapy to treat aggressive chronic myelogenous leukemia. […] Clinical trials are studies of new treatments. These studies provide a chance to try the latest treatments. The risk of side effects might not be known. Ask your health care provider if you might be able to be in a clinical trial.

• #28 Chronic Myeloid Leukemia (CML) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myeloid-leukemia-cml

  The response to TKI therapy is the most important prognostic factor for patients with CML. […] Rarely, other drugs are used as palliation in CML. These drugs include hydroxyurea, busulfan, and recombinant interferon or pegylated interferon. […] Allogeneic stem cell transplantation, because of its toxicity and because of the efficacy of tyrosine kinase inhibitors, is used selectively. Transplantation is reserved for patients with accelerated- or blast-phase CML resistant to BCR-ABL inhibitors. Transplantation can be curative. […] Tyrosine kinase inhibitors are extremely effective, prolong survival, and may even be curative. […] Stem cell transplantation can be curative and may help patients who do not respond to tyrosine kinase inhibitors or who progress to accelerated or blast phase.

• #29 Chronic Myeloid Leukemia (CML) – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/chronic-myeloid-leukemia-cml

  The response to TKI therapy is the most important prognostic factor for patients with CML. […] Rarely, other drugs are used as palliation in CML. These drugs include hydroxyurea, busulfan, and recombinant interferon or pegylated interferon. […] Allogeneic stem cell transplantation, because of its toxicity and because of the efficacy of tyrosine kinase inhibitors, is used selectively. Transplantation is reserved for patients with accelerated- or blast-phase CML resistant to BCR-ABL inhibitors. Transplantation can be curative. […] Tyrosine kinase inhibitors are extremely effective, prolong survival, and may even be curative. […] Stem cell transplantation can be curative and may help patients who do not respond to tyrosine kinase inhibitors or who progress to accelerated or blast phase.

• #30 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422

  A bone marrow transplant, also called a stem cell transplant, is the only treatment that can cure chronic myelogenous leukemia. However, it’s usually reserved for people who haven’t been helped by other treatments. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy medicines are sometimes combined with targeted therapy to treat aggressive chronic myelogenous leukemia. […] Clinical trials are studies of new treatments. These studies provide a chance to try the latest treatments. The risk of side effects might not be known. Ask your health care provider if you might be able to be in a clinical trial.

• #31 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #32 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  TKIs have made a huge difference for people with chronic myeloid leukemia. Before TKIs, only about 20% of people with the condition were alive five years after diagnosis. TKIs changed that outcome for people with early (chronic) CML. […] TKIs put chronic myeloid leukemia into remission. (Remission means you dont have CML symptoms and tests dont find signs of the disease.) Most people take TKIs for the rest of their lives. […] If TKIs arent effective, providers may use chemotherapy along with or instead of a TKI. […] Right now, allogeneic stem cell transplantation is the only way to cure chronic myeloid leukemia. Allogeneic stem cell transplantation uses donated stem cells. Its a complicated medical treatment. Its side effects are more serious than targeted therapy side effects. For that reason, providers typically only use stem cell transplantation to treat resistant CML.

• #33 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  TKIs have made a huge difference for people with chronic myeloid leukemia. Before TKIs, only about 20% of people with the condition were alive five years after diagnosis. TKIs changed that outcome for people with early (chronic) CML. […] TKIs put chronic myeloid leukemia into remission. (Remission means you dont have CML symptoms and tests dont find signs of the disease.) Most people take TKIs for the rest of their lives. […] If TKIs arent effective, providers may use chemotherapy along with or instead of a TKI. […] Right now, allogeneic stem cell transplantation is the only way to cure chronic myeloid leukemia. Allogeneic stem cell transplantation uses donated stem cells. Its a complicated medical treatment. Its side effects are more serious than targeted therapy side effects. For that reason, providers typically only use stem cell transplantation to treat resistant CML.

• #34 Treatments for chronic myeloid leukemia in the chronic phase | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/chronic-phase

  The goal of treatment for chronic myeloid leukemia (CML) in the chronic phase is to reduce the number of granulocytes with the BCR-ABL gene (leukemia cells or CML cells) that are in the blood. This is called a molecular response. […] Targeted therapy is the main treatment for CML in the chronic phase. In rare cases, you may be offered a stem cell transplant. Sometimes chemotherapy is used to treat symptoms before CML is diagnosed. […] Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer. Targeted therapy is the main treatment for almost all people with CML in the chronic phase. […] The targeted therapy drugs used to treat CML are called tyrosine kinase inhibitors (TKIs). […] Imatinib (Gleevec) is the standard TKI given when CML is first treated. The dose may be increased after 3 months if CML doesn’t respond (is resistant) to treatment.

• #35 Chronic Myeloid Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq

  Chronic myeloid leukemia is a disease in which the bone marrow makes too many white blood cells. […] Treatment Option Overview […] There are different types of treatment for patients with chronic myeloid leukemia. […] The following types of treatment are used: Targeted therapy, Chemotherapy, Immunotherapy, High-dose chemotherapy with stem cell transplant (SCT), Donor lymphocyte infusion (DLI), Surgery. […] Treatment for chronic myeloid leukemia may cause side effects. […] Treatment of chronic phase chronic myeloid leukemia may include: targeted therapy (asciminib, imatinib mesylate, nilotinib, dasatinib, bosutinib), allogeneic bone marrow transplant or stem cell transplant. […] Treatment of accelerated phase chronic myeloid leukemia may include: targeted therapy (bosutinib), targeted therapy (imatinib mesylate) followed by allogeneic stem cell transplant.

• #36 Treatments for chronic myeloid leukemia in the chronic phase | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/chronic-phase

  The goal of treatment for chronic myeloid leukemia (CML) in the chronic phase is to reduce the number of granulocytes with the BCR-ABL gene (leukemia cells or CML cells) that are in the blood. This is called a molecular response. […] Targeted therapy is the main treatment for CML in the chronic phase. In rare cases, you may be offered a stem cell transplant. Sometimes chemotherapy is used to treat symptoms before CML is diagnosed. […] Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer. Targeted therapy is the main treatment for almost all people with CML in the chronic phase. […] The targeted therapy drugs used to treat CML are called tyrosine kinase inhibitors (TKIs). […] Imatinib (Gleevec) is the standard TKI given when CML is first treated. The dose may be increased after 3 months if CML doesn’t respond (is resistant) to treatment.

• #37 Treatments for chronic myeloid leukemia in the chronic phase | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/chronic-phase

  The goal of treatment for chronic myeloid leukemia (CML) in the chronic phase is to reduce the number of granulocytes with the BCR-ABL gene (leukemia cells or CML cells) that are in the blood. This is called a molecular response. […] Targeted therapy is the main treatment for CML in the chronic phase. In rare cases, you may be offered a stem cell transplant. Sometimes chemotherapy is used to treat symptoms before CML is diagnosed. […] Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer. Targeted therapy is the main treatment for almost all people with CML in the chronic phase. […] The targeted therapy drugs used to treat CML are called tyrosine kinase inhibitors (TKIs). […] Imatinib (Gleevec) is the standard TKI given when CML is first treated. The dose may be increased after 3 months if CML doesn’t respond (is resistant) to treatment.

• #38 Treatments for chronic myeloid leukemia in the chronic phase | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/chronic-phase

  Dasatinib (Sprycel) or nilotinib (Tasigna) may be given as an alternative to imatinib. They may also be given if the side effects of imatinib are severe or if CML doesn’t respond to imatinib after 6 months. […] Bosutinib (Bosulif) may be given if there are severe side effects from imatinib, dasatinib or nilotinib. Bosutinib is also used if CML doesn’t respond to, or stops responding to, these TKIs after 6 months. […] Ponatinib (Iclusig) may be given if CML doesn’t respond to any of the other TKIs. It is also used if there are other gene mutations in addition to the BCR-ABL gene, such as the T315I gene mutation. […] A stem cell transplant can be used to remove stem cells with the BCR-ABL gene and replace them with healthy ones. But it is a complex procedure and the side effects can be very serious. So a stem cell transplant is rarely used to treat CML in the chronic phase since TKIs became the standard treatment. […] In some cases, chemotherapy may be offered to treat symptoms while your healthcare team is waiting for test results to confirm a diagnosis of CML. The drug used is called hydroxyurea.

• #39 Treatments for chronic myeloid leukemia in the chronic phase | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/chronic-phase

  Dasatinib (Sprycel) or nilotinib (Tasigna) may be given as an alternative to imatinib. They may also be given if the side effects of imatinib are severe or if CML doesn’t respond to imatinib after 6 months. […] Bosutinib (Bosulif) may be given if there are severe side effects from imatinib, dasatinib or nilotinib. Bosutinib is also used if CML doesn’t respond to, or stops responding to, these TKIs after 6 months. […] Ponatinib (Iclusig) may be given if CML doesn’t respond to any of the other TKIs. It is also used if there are other gene mutations in addition to the BCR-ABL gene, such as the T315I gene mutation. […] A stem cell transplant can be used to remove stem cells with the BCR-ABL gene and replace them with healthy ones. But it is a complex procedure and the side effects can be very serious. So a stem cell transplant is rarely used to treat CML in the chronic phase since TKIs became the standard treatment. […] In some cases, chemotherapy may be offered to treat symptoms while your healthcare team is waiting for test results to confirm a diagnosis of CML. The drug used is called hydroxyurea.

• #40 Treatments for chronic myeloid leukemia in the chronic phase | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/chronic-myeloid-leukemia-cml/treatment/chronic-phase

  Dasatinib (Sprycel) or nilotinib (Tasigna) may be given as an alternative to imatinib. They may also be given if the side effects of imatinib are severe or if CML doesn’t respond to imatinib after 6 months. […] Bosutinib (Bosulif) may be given if there are severe side effects from imatinib, dasatinib or nilotinib. Bosutinib is also used if CML doesn’t respond to, or stops responding to, these TKIs after 6 months. […] Ponatinib (Iclusig) may be given if CML doesn’t respond to any of the other TKIs. It is also used if there are other gene mutations in addition to the BCR-ABL gene, such as the T315I gene mutation. […] A stem cell transplant can be used to remove stem cells with the BCR-ABL gene and replace them with healthy ones. But it is a complex procedure and the side effects can be very serious. So a stem cell transplant is rarely used to treat CML in the chronic phase since TKIs became the standard treatment. […] In some cases, chemotherapy may be offered to treat symptoms while your healthcare team is waiting for test results to confirm a diagnosis of CML. The drug used is called hydroxyurea.

• #41 Chronic Myeloid Leukemia (CML) | Treatment by Phase of CML | LLS

  https://www.lls.org/leukemia/chronic-myeloid-leukemia/treatment

  It’s important that your doctor is experienced in treating patients with chronic myeloid leukemia (CML) or has access to a CML specialist. Doctors who specialize in treating patients with CML are called hematologist-oncologists. […] Tyrosine kinase inhibitor (TKI) therapy is standard treatment for chronic phase CML. TKIs are often successful at managing CML for long periods of time. The following TKIs are approved as primary treatment for chronic phase CML: Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), Asciminib (Scemblix). […] The goal in treating accelerated phase CML, just as with the chronic phase, is to eliminate all cells that contain the BCR::ABL1 gene, leading to a remission. […] Treatment options for accelerated phase CML depend on the patients previous treatments. If CML is diagnosed in the accelerated phase and the patient has not yet tried a TKI, one treatment option is to begin TKI therapy.

• #42 Chronic Myeloid Leukemia (CML) | Treatment by Phase of CML | LLS

  https://www.lls.org/leukemia/chronic-myeloid-leukemia/treatment

  It’s important that your doctor is experienced in treating patients with chronic myeloid leukemia (CML) or has access to a CML specialist. Doctors who specialize in treating patients with CML are called hematologist-oncologists. […] Tyrosine kinase inhibitor (TKI) therapy is standard treatment for chronic phase CML. TKIs are often successful at managing CML for long periods of time. The following TKIs are approved as primary treatment for chronic phase CML: Imatinib (Gleevec), Dasatinib (Sprycel), Nilotinib (Tasigna), Bosutinib (Bosulif), Asciminib (Scemblix). […] The goal in treating accelerated phase CML, just as with the chronic phase, is to eliminate all cells that contain the BCR::ABL1 gene, leading to a remission. […] Treatment options for accelerated phase CML depend on the patients previous treatments. If CML is diagnosed in the accelerated phase and the patient has not yet tried a TKI, one treatment option is to begin TKI therapy.

• #43 Chronic Myeloid Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq

  Chronic myeloid leukemia is a disease in which the bone marrow makes too many white blood cells. […] Treatment Option Overview […] There are different types of treatment for patients with chronic myeloid leukemia. […] The following types of treatment are used: Targeted therapy, Chemotherapy, Immunotherapy, High-dose chemotherapy with stem cell transplant (SCT), Donor lymphocyte infusion (DLI), Surgery. […] Treatment for chronic myeloid leukemia may cause side effects. […] Treatment of chronic phase chronic myeloid leukemia may include: targeted therapy (asciminib, imatinib mesylate, nilotinib, dasatinib, bosutinib), allogeneic bone marrow transplant or stem cell transplant. […] Treatment of accelerated phase chronic myeloid leukemia may include: targeted therapy (bosutinib), targeted therapy (imatinib mesylate) followed by allogeneic stem cell transplant.

• #44 Chronic Myeloid Leukemia Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq

  Treatment of patients with chronic myeloid leukemia (CML) is usually initiated at diagnosis, which is based on the presence of an elevated white blood cell count, splenomegaly, thrombocytosis, and identification of the BCR::ABL1 translocation. […] The optimal front-line treatment for patients with chronic-phase CML involves specific inhibitors of the BCR::ABL1 tyrosine kinase. […] Allogeneic BMT or SCT has also been used with curative intent. […] Long-term data are also available for patients treated with interferon alfa. […] Hydroxyurea is superior to busulfan in the chronic phase of CML, with significantly longer median survival and significantly fewer severe adverse effects. […] Treatment options for chronic-phase chronic myeloid leukemia (CML) include: Targeted therapy with an allosteric inhibitor of BCR::ABL1 at the ABL1 myristoyl pocket (asciminib), Targeted therapy with other BCR::ABL1 tyrosine kinase inhibitors (TKIs) (nilotinib, dasatinib, bosutinib, or imatinib), Allogeneic bone marrow transplant (BMT) or stem cell transplant (SCT).

• #45 Chronic Myeloid Leukemia (CML) | Treatment by Phase of CML | LLS

  https://www.lls.org/leukemia/chronic-myeloid-leukemia/treatment

  The leukemia cells in patients with blast phase CML have become very abnormal. Blast phase CML is similar to acute leukemia, with higher blood cell counts and more severe symptoms. […] Treatment options include: TKI therapy, either with or without chemotherapy, and then an allogeneic stem cell transplantation, a clinical trial.

• #46 Chronic Myeloid Leukemia (CML) | Treatment by Phase of CML | LLS

  https://www.lls.org/leukemia/chronic-myeloid-leukemia/treatment

  The leukemia cells in patients with blast phase CML have become very abnormal. Blast phase CML is similar to acute leukemia, with higher blood cell counts and more severe symptoms. […] Treatment options include: TKI therapy, either with or without chemotherapy, and then an allogeneic stem cell transplantation, a clinical trial.

• #47 Chronic Myeloid Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq

  Treatment of blastic phase chronic myeloid leukemia may include: targeted therapy (imatinib mesylate, dasatinib, nilotinib, bosutinib), allogeneic bone marrow transplant or stem cell transplant, chemotherapy as palliative therapy to relieve symptoms and improve quality of life. […] In relapsed chronic myeloid leukemia (CML), the number of blast cells increases after a remission. Treatment of relapsed CML may include targeted therapy (ponatinib or asciminib).

• #48 Treatment for Chronic Myeloid Leukemia (CML) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/leukemias/treatment/chronic-myeloid-leukemia

  Patients may also receive transfusions of blood or blood products to relieve symptoms. […] If your disease is in the blast phase, treatment is likely to include chemotherapy in addition to imatinib, dasatinib, or nilotinib. […] This is a difficult phase of the disease to treat. […] Often, stem cell transplantation is recommended if an appropriate donor is available and you are healthy enough to undergo the procedure. […] Because the best results with stem cell transplantation occur when CML is in the chronic or early accelerated phase, the goal of treatment during the blast phase is to first get the patient back to an earlier phase of the disease before transplantation takes place. […] Researchers are studying the most-effective ways to use the targeted therapies that are now available (imatinib, dasatinib, and nilotinib).

• #49 Treatment for Chronic Myeloid Leukemia (CML) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/leukemias/treatment/chronic-myeloid-leukemia

  Patients may also receive transfusions of blood or blood products to relieve symptoms. […] If your disease is in the blast phase, treatment is likely to include chemotherapy in addition to imatinib, dasatinib, or nilotinib. […] This is a difficult phase of the disease to treat. […] Often, stem cell transplantation is recommended if an appropriate donor is available and you are healthy enough to undergo the procedure. […] Because the best results with stem cell transplantation occur when CML is in the chronic or early accelerated phase, the goal of treatment during the blast phase is to first get the patient back to an earlier phase of the disease before transplantation takes place. […] Researchers are studying the most-effective ways to use the targeted therapies that are now available (imatinib, dasatinib, and nilotinib).

• #50 Chronic Myeloid Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq

  Treatment of blastic phase chronic myeloid leukemia may include: targeted therapy (imatinib mesylate, dasatinib, nilotinib, bosutinib), allogeneic bone marrow transplant or stem cell transplant, chemotherapy as palliative therapy to relieve symptoms and improve quality of life. […] In relapsed chronic myeloid leukemia (CML), the number of blast cells increases after a remission. Treatment of relapsed CML may include targeted therapy (ponatinib or asciminib).

• #51 Chronic Myeloid Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq

  Treatment of blastic phase chronic myeloid leukemia may include: targeted therapy (imatinib mesylate, dasatinib, nilotinib, bosutinib), allogeneic bone marrow transplant or stem cell transplant, chemotherapy as palliative therapy to relieve symptoms and improve quality of life. […] In relapsed chronic myeloid leukemia (CML), the number of blast cells increases after a remission. Treatment of relapsed CML may include targeted therapy (ponatinib or asciminib).

• #52 Tyrosine kinase inhibitors (TKIs) | Blood Cancer UK

  https://bloodcancer.org.uk/understanding-blood-cancer/leukaemia/chronic-myeloid-leukaemia-cml/cml-treatment-side-effects/tyrosine-kinase-inhibitors/

  Most people with CML are prescribed a tyrosine kinase inhibitor (TKI). This is a drug that comes in tablet form which you take daily. […] When you’re first diagnosed, your hospital team will discuss which TKI is best for you. The treatment they recommend is known as your first line treatment. Most people start on imatinib, which was the first TKI to be developed over twenty years ago. […] If the first TKI you try stops working for you or becomes less effective, your doctor will suggest trying a different one. […] If you struggle to tolerate at least two different TKIs, your doctor may recommend trying a newer or different type of TKI. One example is a TKI called asciminib. […] The TKI you are given first will depend on what phase of CML you have, as well as things like your age, the potential risk of side effects, and any other conditions you have.

• #53 Tyrosine kinase inhibitors (TKIs) | Blood Cancer UK

  https://bloodcancer.org.uk/understanding-blood-cancer/leukaemia/chronic-myeloid-leukaemia-cml/cml-treatment-side-effects/tyrosine-kinase-inhibitors/

  Most people with CML are prescribed a tyrosine kinase inhibitor (TKI). This is a drug that comes in tablet form which you take daily. […] When you’re first diagnosed, your hospital team will discuss which TKI is best for you. The treatment they recommend is known as your first line treatment. Most people start on imatinib, which was the first TKI to be developed over twenty years ago. […] If the first TKI you try stops working for you or becomes less effective, your doctor will suggest trying a different one. […] If you struggle to tolerate at least two different TKIs, your doctor may recommend trying a newer or different type of TKI. One example is a TKI called asciminib. […] The TKI you are given first will depend on what phase of CML you have, as well as things like your age, the potential risk of side effects, and any other conditions you have.

• #54 Treatment for chronic myeloid leukaemia (CML) – Leukaemia Care

  https://www.leukaemiacare.org.uk/support-and-information/information-about-blood-cancer/blood-cancer-information/leukaemia/chronic-myeloid-leukaemia/treatment-for-chronic-myeloid-leukaemia/

  If your CML is in the blast phase, your doctors might suggest adding chemotherapy to your TKI. They could advise a stem cell transplant as well. […] Tyrosine kinase inhibitors (TKIs) are a type of targeted therapy. They block an abnormal protein called BCR-ABL, which is a type of tyrosine kinase. […] TKIs are tablets that you take by mouth. They are generally highly effective at keeping CML under control. […] You might be offered chemotherapy as well as a TKI if your CML is in the blast phase. […] A stem cell transplant involves having high-dose chemotherapy to kill blood-forming stem cells in your bone marrow. These are then replaced by healthy stem cells from a matched donor. […] Your haematology team might suggest a stem cell transplant if your CML is in the blast phase. […] If your treatment is not successful, your haematology team will suggest changing to a different treatment. […] For most people, the usual second treatment is a different TKI. If second-line TKI treatment is not successful, the usual next treatment is another TKI. […] TKIs are effective for most people, but if they are not suitable for you, your haematology team will discuss other treatment options.

• #55 Chronic myeloid leukemia: 2025 update on diagnosis, therapy, and monitoring – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39093014/

  For CML post-failure on frontline therapy, second-line options include second and third-generation TKIs. Although potent and selective, these TKIs exhibit unique pharmacological profiles and response patterns relative to different patient and disease characteristics, such as patients’ comorbidities and financial status, disease stage, and BCR::ABL1 mutational status. Patients who develop the T315I „gatekeeper” mutation display resistance to all currently available TKIs except ponatinib, asciminib, and olverembatinib. Allogeneic stem cell transplantation remains an important therapeutic option for patients with CML-CP and failure (due to resistance) of at least two TKIs and for all patients in advanced-phase disease. Older patients who have a cytogenetic relapse post-failure on all TKIs can maintain long-term survival if they continue a daily most effective/least toxic TKI, with or without the addition of non-TKI anti-CML agents (hydroxyurea, omacetaxine, azacitidine, decitabine, cytarabine, and others).

• #56 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #57 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #58 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #59 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #60 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #61 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  TKIs have made a huge difference for people with chronic myeloid leukemia. Before TKIs, only about 20% of people with the condition were alive five years after diagnosis. TKIs changed that outcome for people with early (chronic) CML. […] TKIs put chronic myeloid leukemia into remission. (Remission means you dont have CML symptoms and tests dont find signs of the disease.) Most people take TKIs for the rest of their lives. […] If TKIs arent effective, providers may use chemotherapy along with or instead of a TKI. […] Right now, allogeneic stem cell transplantation is the only way to cure chronic myeloid leukemia. Allogeneic stem cell transplantation uses donated stem cells. Its a complicated medical treatment. Its side effects are more serious than targeted therapy side effects. For that reason, providers typically only use stem cell transplantation to treat resistant CML.

• #62 Chronic Myeloid Leukemia (CML): Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/blood-cancers/chronic-myelogenous-leukemia-cml/chronic-myeloid-leukemia-cml-staging-and-treatment

  Bone marrow transplants are not a first-line therapy for CML patients but may be used in patients who are no longer responding to TKI therapy. […] Other types of treatments may be used in cases where TKIs are no longer working to manage the disease. These include: […] Omacetaxine mepesuccinate (Synribo) is a manmade form of homoharringtonine, a compound purified from a Chinese evergreen tree. It can be used in patients who have not responded to 2 or more TKI medications. […] Interferon alfa may be used in pregnant women and for others who cannot have a transplant. […] Chemotherapy: May be used in combination with TKI in preparation for transplant. […] Radiation: May be used to palliate (relieve) symptoms related to bone pain or an enlarged spleen. […] Surgery: In some people with CML, the spleen can become enlarged and press against other organs. A splenectomy (removal of the spleen) may be needed.

• #63 Treatment options for chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/treatment/treatment-decisions

  A team of health professionals decides what treatment options you have. The most common treatments for chronic myeloid leukaemia (CML) are targeted cancer drugs. These drugs are called tyrosine kinase inhibitors (TKIs). […] The main treatment for CML are targeted cancer drugs. Other possible treatments include chemotherapy and a stem cell transplant. […] Targeted cancer drugs can change the way that cells work and help the body control the growth of cancer. There are different types of targeted cancer drugs. The main type for CML are: tyrosine kinase inhibitors (TKIs). […] Examples of TKI drugs for CML are imatinib, bosutinib, dasatinib and nilotinib. […] Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream. Fludarabine, idarubicin and cytarabine are examples of chemotherapy drugs for CML.

• #64 Treatment options for chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/treatment/treatment-decisions

  You usually only have chemotherapy if you have more advanced stages of CML. […] You have a stem cell transplant after very high doses of chemotherapy. The chemotherapy kills the cancer cells and also the stem cells in your bone marrow. […] The most common treatment is a type of targeted cancer drug called a tyrosine kinase inhibitor (TKI). […] Most people respond well to this treatment. CML can stay under control for many years. […] Occasionally TKI treatment does not work. In this situation your doctor might offer you chemotherapy and a stem cell transplant. […] The aim of second line treatment is to put your CML back into remission. Remission means there are no signs of CML in your blood. […] Supportive treatments can help to either prevent or control these problems. […] There are several other treatments you might have for CML: A chemotherapy drug called hydroxycarbamide. This is to lower your white blood or platelet levels. […] Your doctor usually recommends you have a stem cell transplant if you are well enough and have a stem cell donor.

• #65 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #66 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #67 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  Stem cell transplant. This treatment is sometimes used for CML. But it’s mostly used in younger people because it offers the best chance for a cure. It might be a choice if other treatments, such as targeted therapy, are no longer working. Before the transplant, you get high doses of chemotherapy. And sometimes you’ll get radiation therapy, too. This is done to destroy almost all your bone marrow. Then stem cells from a healthy donor are used to replace your bone marrow. […] Immunotherapy. This treatment uses medicines to help your immune system fight leukemia. Interferon is the most common type of immunotherapy used to treat CML. It’s not used very often because other, newer treatments work better. […] Chemotherapy (chemo). This treatment uses strong medicines to kill cancer cells. It’s not a common treatment for CML. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The most common chemo medicine used for CML is hydroxyurea. It can control the number of leukemia cells, but it can’t cure the disease.

• #68 Chronic Myeloid Leukemia (CML): Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/blood-cancers/chronic-myelogenous-leukemia-cml/chronic-myeloid-leukemia-cml-staging-and-treatment

  Bone marrow transplants are not a first-line therapy for CML patients but may be used in patients who are no longer responding to TKI therapy. […] Other types of treatments may be used in cases where TKIs are no longer working to manage the disease. These include: […] Omacetaxine mepesuccinate (Synribo) is a manmade form of homoharringtonine, a compound purified from a Chinese evergreen tree. It can be used in patients who have not responded to 2 or more TKI medications. […] Interferon alfa may be used in pregnant women and for others who cannot have a transplant. […] Chemotherapy: May be used in combination with TKI in preparation for transplant. […] Radiation: May be used to palliate (relieve) symptoms related to bone pain or an enlarged spleen. […] Surgery: In some people with CML, the spleen can become enlarged and press against other organs. A splenectomy (removal of the spleen) may be needed.

• #69 Get Chronic Myelogenous Leukemia Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/chronic-myelogenous-leukemia-treatment

  Chemotherapy uses anticancer drugs to destroy leukemia cells. It may be used in combination with targeted therapy. Or we may recommend it if targeted therapy doesn’t work as well as planned. […] Your body’s immune system makes interferons (proteins that help your immune system fight cancer and slow cancer cell growth). This treatment uses synthetic (human-made) interferons (interferon alpha-2b injection) that are similar to those in your body to help reduce the growth of leukemia cells. […] For some people, we may need to discuss having a bone marrow transplant (stem cell transplant). This treatment recreates your white blood cells using healthy stem cells, usually from a donor. […] When you have CML and need a bone marrow transplant, you may need to spend four to six weeks in the hospital.

• #70 Treatment options for chronic myeloid leukaemia (CML) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/chronic-myeloid-leukaemia-cml/treatment/treatment-decisions

  You usually only have chemotherapy if you have more advanced stages of CML. […] You have a stem cell transplant after very high doses of chemotherapy. The chemotherapy kills the cancer cells and also the stem cells in your bone marrow. […] The most common treatment is a type of targeted cancer drug called a tyrosine kinase inhibitor (TKI). […] Most people respond well to this treatment. CML can stay under control for many years. […] Occasionally TKI treatment does not work. In this situation your doctor might offer you chemotherapy and a stem cell transplant. […] The aim of second line treatment is to put your CML back into remission. Remission means there are no signs of CML in your blood. […] Supportive treatments can help to either prevent or control these problems. […] There are several other treatments you might have for CML: A chemotherapy drug called hydroxycarbamide. This is to lower your white blood or platelet levels. […] Your doctor usually recommends you have a stem cell transplant if you are well enough and have a stem cell donor.

• #71 Treatment for chronic myeloid leukaemia – NHS

  https://www.nhs.uk/conditions/chronic-myeloid-leukaemia/treatment/

  Chronic myeloid leukaemia (CML) usually develops very slowly. You may not need treatment straight away. […] Treatment will depend on: the phase (or stage) of your CML, your age, your general health. […] It will usually include targeted cancer medicines. You may also be offered chemotherapy or a stem cell transplant. […] Treatments to prevent and manage symptoms (called supportive treatments) will also be offered. […] The main treatment for CML is targeted medicines called tyrosine kinase inhibitors (TKIs). […] Some people with CML need to have chemotherapy. […] You may need to have chemotherapy to control your symptoms, before having a stem cell transplant, if your CML is in the acute (blast) phase. […] You may need to have a stem cell transplant to treat CML if targeted cancer drugs are no longer working to control your cancer, your cancer is in the acute (blast) phase or accelerated phase. […] You may need treatment to help with symptoms caused by CML or by the cancer medicines and chemotherapy. […] Supportive treatments may include: medicines such as antibiotics to treat infections, blood transfusions, vaccines to help protect you from illnesses such as flu and COVID-19.

• #72 Chronic Myeloid Leukemia (CML): Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/blood-cancers/chronic-myelogenous-leukemia-cml/chronic-myeloid-leukemia-cml-staging-and-treatment

  Bone marrow transplants are not a first-line therapy for CML patients but may be used in patients who are no longer responding to TKI therapy. […] Other types of treatments may be used in cases where TKIs are no longer working to manage the disease. These include: […] Omacetaxine mepesuccinate (Synribo) is a manmade form of homoharringtonine, a compound purified from a Chinese evergreen tree. It can be used in patients who have not responded to 2 or more TKI medications. […] Interferon alfa may be used in pregnant women and for others who cannot have a transplant. […] Chemotherapy: May be used in combination with TKI in preparation for transplant. […] Radiation: May be used to palliate (relieve) symptoms related to bone pain or an enlarged spleen. […] Surgery: In some people with CML, the spleen can become enlarged and press against other organs. A splenectomy (removal of the spleen) may be needed.

• #73 Chronic Myeloid Leukemia (CML): Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/blood-cancers/chronic-myelogenous-leukemia-cml/chronic-myeloid-leukemia-cml-staging-and-treatment

  Bone marrow transplants are not a first-line therapy for CML patients but may be used in patients who are no longer responding to TKI therapy. […] Other types of treatments may be used in cases where TKIs are no longer working to manage the disease. These include: […] Omacetaxine mepesuccinate (Synribo) is a manmade form of homoharringtonine, a compound purified from a Chinese evergreen tree. It can be used in patients who have not responded to 2 or more TKI medications. […] Interferon alfa may be used in pregnant women and for others who cannot have a transplant. […] Chemotherapy: May be used in combination with TKI in preparation for transplant. […] Radiation: May be used to palliate (relieve) symptoms related to bone pain or an enlarged spleen. […] Surgery: In some people with CML, the spleen can become enlarged and press against other organs. A splenectomy (removal of the spleen) may be needed.

• #74 Chronic Myeloid Leukemia (CML): Treatment Choices | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/chronic-myeloid-leukemia-cml-treatment-choices

  Chemotherapy uses strong medicines to kill cancer cells. It’s not a common treatment for CML. […] Radiation therapy uses strong X-rays to kill cancer cells. It can be used to kill leukemia cells that have spread to an organ, such as your spleen. […] A splenectomy is surgery to take out your spleen. Your spleen may be removed to improve your blood cell counts or to reduce pressure on other organs caused by a swollen spleen. Still, this surgery is not often used for CML. […] Researchers are always finding new ways to treat CML. These new methods are tested in clinical trials.

• #75 Chronic Myeloid Leukemia (CML): Treatment Choices | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/chronic-myeloid-leukemia-cml-treatment-choices

  Chemotherapy uses strong medicines to kill cancer cells. It’s not a common treatment for CML. […] Radiation therapy uses strong X-rays to kill cancer cells. It can be used to kill leukemia cells that have spread to an organ, such as your spleen. […] A splenectomy is surgery to take out your spleen. Your spleen may be removed to improve your blood cell counts or to reduce pressure on other organs caused by a swollen spleen. Still, this surgery is not often used for CML. […] Researchers are always finding new ways to treat CML. These new methods are tested in clinical trials.

• #76 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Chronic-Myeloid-Leukemia-Treatment.aspx

  It is useful to have access to several types of tyrosine kinase inhibitors, particularly in the event of resistance to one of these drugs. […] There are also several other pharmaceutical agents that may be used in the management of chronic myeloid leukemia. […] There are two treatments that have the potential to cure chronic myeloid leukemia: a bone marrow transplant or an allogeneic stem cell transplant. […] The introduction of tyrosine kinase inhibitors in the treatment of CML has helped to improve the prognosis of patients significantly.

• #77 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  TKIs have made a huge difference for people with chronic myeloid leukemia. Before TKIs, only about 20% of people with the condition were alive five years after diagnosis. TKIs changed that outcome for people with early (chronic) CML. […] TKIs put chronic myeloid leukemia into remission. (Remission means you dont have CML symptoms and tests dont find signs of the disease.) Most people take TKIs for the rest of their lives. […] If TKIs arent effective, providers may use chemotherapy along with or instead of a TKI. […] Right now, allogeneic stem cell transplantation is the only way to cure chronic myeloid leukemia. Allogeneic stem cell transplantation uses donated stem cells. Its a complicated medical treatment. Its side effects are more serious than targeted therapy side effects. For that reason, providers typically only use stem cell transplantation to treat resistant CML.

• #78 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  TKIs have made a huge difference for people with chronic myeloid leukemia. Before TKIs, only about 20% of people with the condition were alive five years after diagnosis. TKIs changed that outcome for people with early (chronic) CML. […] TKIs put chronic myeloid leukemia into remission. (Remission means you dont have CML symptoms and tests dont find signs of the disease.) Most people take TKIs for the rest of their lives. […] If TKIs arent effective, providers may use chemotherapy along with or instead of a TKI. […] Right now, allogeneic stem cell transplantation is the only way to cure chronic myeloid leukemia. Allogeneic stem cell transplantation uses donated stem cells. Its a complicated medical treatment. Its side effects are more serious than targeted therapy side effects. For that reason, providers typically only use stem cell transplantation to treat resistant CML.

• #79 Chronic Myeloid Leukemia (CML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21845-chronic-myelogenous-leukemia-cml

  TKIs have made a huge difference for people with chronic myeloid leukemia. Before TKIs, only about 20% of people with the condition were alive five years after diagnosis. TKIs changed that outcome for people with early (chronic) CML. […] TKIs put chronic myeloid leukemia into remission. (Remission means you dont have CML symptoms and tests dont find signs of the disease.) Most people take TKIs for the rest of their lives. […] If TKIs arent effective, providers may use chemotherapy along with or instead of a TKI. […] Right now, allogeneic stem cell transplantation is the only way to cure chronic myeloid leukemia. Allogeneic stem cell transplantation uses donated stem cells. Its a complicated medical treatment. Its side effects are more serious than targeted therapy side effects. For that reason, providers typically only use stem cell transplantation to treat resistant CML.

• #80 Chronic myelogenous leukemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/symptoms-causes/syc-20352417

  Advances in treatment have improved the prognosis of people with chronic myelogenous leukemia. Most people can achieve remission and live for many years after diagnosis. […] Chronic myelogenous leukemia treatment (PDQ). National Cancer Institute. http://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq. Accessed Jan. 3, 2016. […] Negrin RS, et al. Overview of the treatment of chronic myeloid leukemia. http://www.uptodate.com/home. Accessed Jan. 13, 2016.

• #81 Chronic myeloid leukaemia treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/treatment/

  Chronic myeloid leukaemia treatment […] How is CML treated? The treatment chosen for your CML largely depends on the phase of your disease, your age and general health. Most people with CML will be treated with drugs called tyrosine kinase inhibitors (TKIs). TKIs work by blocking the activity of an enzyme called bcr-abl and thereby preventing the growth and proliferation of the leukaemic cells. The most common decision to be made at diagnosis is which of the available TKI drugs is most suited to you. This varies from person to person and your doctor will examine all the information about you that is available to them to decide on the most suitable option. […] While these drugs are very effective at controlling the disease, most people are required to take these medications for life to keep the disease under control. Only a minority of patients may be ‘cured’ by TKI therapy and are able to safely stop taking them. People with well-controlled CML are expected to have a normal life expectancy. […] In a very small number of patients, a stem cell transplant from a matched donor may be considered. This is only considered in patients who do not respond well to TKI therapy and have progressive CML. This treatment, although offering the prospect of a cure, carries serious risks. […] While you are in the chronic phase of CML, treatment is aimed at controlling your disease, prolonging this phase and delaying the onset of symptoms and complications for as long as possible. When you are first diagnosed with CML it can take one to two weeks to start therapy with a TKI. […] Adherence, also commonly called compliance, to treatment with TKIs for CML is very important for the drugs to work effectively. If there is not enough drug in the body (due to skipped doses), it is possible that the CML cells may become resistant via a process called mutation. Some mutations do not respond well to TKIs, therefore it is very important to take your medication as directed and do not make any changes without discussing it first with your haematologist. […] Although uncommon, some people already have advanced disease at diagnosis, while others may experience disease progression. Advanced phase treatment is aimed at re-establishing the chronic phase of CML and reducing any troublesome symptoms. There are several treatment options that may be used. The treatment of accelerated and blast phase CML usually involves a more intensive approach. These include more intensive chemotherapy using a combination of drugs similar to those used to treat acute leukaemia in combination with a different TKI. […] A stem cell transplant is now generally only used for people in whom the CML has not responded to TKIs, or who were diagnosed in the accelerated phase. Some patients may benefit by participating in a clinical trial.

• #82 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  Discontinuing the TKI after a sustained DMR of 2 years results in 3-year TFR rates of 40%50%, while discontinuation after a DMR of 5 years results in a 5-year TFR rate of 80%. […] The achievement of TFR has been estimated to be about 2530%. […] In patients who do not have high-risk CML features (high-risk additional cytogenetic abnormality, mutations in genes such as ASXL1) and in whom TFR is not an aim, it is reasonable to continue the same TKI at the same dose, provided the patient tolerates the drug well, maintains compliance to therapy and is monitored every 36 months. […] The treatment options in patients with ABL1-T315I mutation have evolved with the approval of ponatinib and asciminib, and the promising results from reported and ongoing trials of olverembatinib.

• #83 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  Discontinuing the TKI after a sustained DMR of 2 years results in 3-year TFR rates of 40%50%, while discontinuation after a DMR of 5 years results in a 5-year TFR rate of 80%. […] The achievement of TFR has been estimated to be about 2530%. […] In patients who do not have high-risk CML features (high-risk additional cytogenetic abnormality, mutations in genes such as ASXL1) and in whom TFR is not an aim, it is reasonable to continue the same TKI at the same dose, provided the patient tolerates the drug well, maintains compliance to therapy and is monitored every 36 months. […] The treatment options in patients with ABL1-T315I mutation have evolved with the approval of ponatinib and asciminib, and the promising results from reported and ongoing trials of olverembatinib.

• #84 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  Discontinuing the TKI after a sustained DMR of 2 years results in 3-year TFR rates of 40%50%, while discontinuation after a DMR of 5 years results in a 5-year TFR rate of 80%. […] The achievement of TFR has been estimated to be about 2530%. […] In patients who do not have high-risk CML features (high-risk additional cytogenetic abnormality, mutations in genes such as ASXL1) and in whom TFR is not an aim, it is reasonable to continue the same TKI at the same dose, provided the patient tolerates the drug well, maintains compliance to therapy and is monitored every 36 months. […] The treatment options in patients with ABL1-T315I mutation have evolved with the approval of ponatinib and asciminib, and the promising results from reported and ongoing trials of olverembatinib.

• #85 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The main treatment for chronic myeloid leukaemia (CML) is a group of targeted therapy drugs called tyrosine kinase inhibitors (TKIs). […] Each TKI works in a slightly different way. This means that if one TKI doesn’t control the CML or stops working for you, your doctor may increase the dose or switch you to another type of TKI. […] A new generation TKI, asciminib, is available for people with CML who cannot tolerate or have developed resistance to older TKIs. […] TKIs can cause the signs and symptoms of CML to reduce or disappear. Most people are able to return to their usual activities. The drugs will need to be taken throughout your life, and you will need to have regular blood tests to check CML hasn’t returned. […] Some people who have had an excellent response to a TKI for at least three years may be able to stop taking these drugs. If you are able to stop, you’ll need frequent check-ups. Half the people who stop have no further issues, and the other half have a relapse and need to start taking TKIs again.

• #86 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The main treatment for chronic myeloid leukaemia (CML) is a group of targeted therapy drugs called tyrosine kinase inhibitors (TKIs). […] Each TKI works in a slightly different way. This means that if one TKI doesn’t control the CML or stops working for you, your doctor may increase the dose or switch you to another type of TKI. […] A new generation TKI, asciminib, is available for people with CML who cannot tolerate or have developed resistance to older TKIs. […] TKIs can cause the signs and symptoms of CML to reduce or disappear. Most people are able to return to their usual activities. The drugs will need to be taken throughout your life, and you will need to have regular blood tests to check CML hasn’t returned. […] Some people who have had an excellent response to a TKI for at least three years may be able to stop taking these drugs. If you are able to stop, you’ll need frequent check-ups. Half the people who stop have no further issues, and the other half have a relapse and need to start taking TKIs again.

• #87 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The side effects of TKIs vary depending on the drug and how your body responds. Most side effects are mild and can be treated. […] Your doctor may be able to prescribe medicine to prevent or reduce side effects. Sometimes your doctor may have to change the dose of the TKI or give you a different TKI. […] Many TKIs, such as imatinib, are not safe to use during pregnancy or while breastfeeding.

• #88 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The side effects of TKIs vary depending on the drug and how your body responds. Most side effects are mild and can be treated. […] Your doctor may be able to prescribe medicine to prevent or reduce side effects. Sometimes your doctor may have to change the dose of the TKI or give you a different TKI. […] Many TKIs, such as imatinib, are not safe to use during pregnancy or while breastfeeding.

• #89 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422

  The goal of chronic myelogenous leukemia treatment is to eliminate the blood cells that contain the BCR-ABL gene. For most people, treatment begins with targeted therapy that may help achieve a long-term remission of the disease. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted therapy can cause cancer cells to die. In chronic myelogenous leukemia, the target of these medicines is the tyrosine kinase protein produced by the BCR-ABL gene. The medicines are called tyrosine kinase inhibitors, also known as TKIs. […] TKIs are the initial treatment for people diagnosed with chronic myelogenous leukemia. Side effects of these targeted medicines include swelling or puffiness of the skin, nausea, muscle cramps, fatigue, diarrhea, and skin rashes.

• #90 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The side effects of TKIs vary depending on the drug and how your body responds. Most side effects are mild and can be treated. […] Your doctor may be able to prescribe medicine to prevent or reduce side effects. Sometimes your doctor may have to change the dose of the TKI or give you a different TKI. […] Many TKIs, such as imatinib, are not safe to use during pregnancy or while breastfeeding.

• #91 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The side effects of TKIs vary depending on the drug and how your body responds. Most side effects are mild and can be treated. […] Your doctor may be able to prescribe medicine to prevent or reduce side effects. Sometimes your doctor may have to change the dose of the TKI or give you a different TKI. […] Many TKIs, such as imatinib, are not safe to use during pregnancy or while breastfeeding.

• #92 Targeted Therapy for Chronic Myeloid Leukaemia (CML) | Cancer Council NSW

  https://www.cancercouncil.com.au/chronic-myeloid-leukaemia/treatment/targeted-therapies/

  The side effects of TKIs vary depending on the drug and how your body responds. Most side effects are mild and can be treated. […] Your doctor may be able to prescribe medicine to prevent or reduce side effects. Sometimes your doctor may have to change the dose of the TKI or give you a different TKI. […] Many TKIs, such as imatinib, are not safe to use during pregnancy or while breastfeeding.

• #93 Chronic myeloid leukaemia treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/treatment/

  Chronic myeloid leukaemia treatment […] How is CML treated? The treatment chosen for your CML largely depends on the phase of your disease, your age and general health. Most people with CML will be treated with drugs called tyrosine kinase inhibitors (TKIs). TKIs work by blocking the activity of an enzyme called bcr-abl and thereby preventing the growth and proliferation of the leukaemic cells. The most common decision to be made at diagnosis is which of the available TKI drugs is most suited to you. This varies from person to person and your doctor will examine all the information about you that is available to them to decide on the most suitable option. […] While these drugs are very effective at controlling the disease, most people are required to take these medications for life to keep the disease under control. Only a minority of patients may be ‘cured’ by TKI therapy and are able to safely stop taking them. People with well-controlled CML are expected to have a normal life expectancy. […] In a very small number of patients, a stem cell transplant from a matched donor may be considered. This is only considered in patients who do not respond well to TKI therapy and have progressive CML. This treatment, although offering the prospect of a cure, carries serious risks. […] While you are in the chronic phase of CML, treatment is aimed at controlling your disease, prolonging this phase and delaying the onset of symptoms and complications for as long as possible. When you are first diagnosed with CML it can take one to two weeks to start therapy with a TKI. […] Adherence, also commonly called compliance, to treatment with TKIs for CML is very important for the drugs to work effectively. If there is not enough drug in the body (due to skipped doses), it is possible that the CML cells may become resistant via a process called mutation. Some mutations do not respond well to TKIs, therefore it is very important to take your medication as directed and do not make any changes without discussing it first with your haematologist. […] Although uncommon, some people already have advanced disease at diagnosis, while others may experience disease progression. Advanced phase treatment is aimed at re-establishing the chronic phase of CML and reducing any troublesome symptoms. There are several treatment options that may be used. The treatment of accelerated and blast phase CML usually involves a more intensive approach. These include more intensive chemotherapy using a combination of drugs similar to those used to treat acute leukaemia in combination with a different TKI. […] A stem cell transplant is now generally only used for people in whom the CML has not responded to TKIs, or who were diagnosed in the accelerated phase. Some patients may benefit by participating in a clinical trial.

• #94 Chronic myeloid leukaemia treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/treatment/

  Chronic myeloid leukaemia treatment […] How is CML treated? The treatment chosen for your CML largely depends on the phase of your disease, your age and general health. Most people with CML will be treated with drugs called tyrosine kinase inhibitors (TKIs). TKIs work by blocking the activity of an enzyme called bcr-abl and thereby preventing the growth and proliferation of the leukaemic cells. The most common decision to be made at diagnosis is which of the available TKI drugs is most suited to you. This varies from person to person and your doctor will examine all the information about you that is available to them to decide on the most suitable option. […] While these drugs are very effective at controlling the disease, most people are required to take these medications for life to keep the disease under control. Only a minority of patients may be ‘cured’ by TKI therapy and are able to safely stop taking them. People with well-controlled CML are expected to have a normal life expectancy. […] In a very small number of patients, a stem cell transplant from a matched donor may be considered. This is only considered in patients who do not respond well to TKI therapy and have progressive CML. This treatment, although offering the prospect of a cure, carries serious risks. […] While you are in the chronic phase of CML, treatment is aimed at controlling your disease, prolonging this phase and delaying the onset of symptoms and complications for as long as possible. When you are first diagnosed with CML it can take one to two weeks to start therapy with a TKI. […] Adherence, also commonly called compliance, to treatment with TKIs for CML is very important for the drugs to work effectively. If there is not enough drug in the body (due to skipped doses), it is possible that the CML cells may become resistant via a process called mutation. Some mutations do not respond well to TKIs, therefore it is very important to take your medication as directed and do not make any changes without discussing it first with your haematologist. […] Although uncommon, some people already have advanced disease at diagnosis, while others may experience disease progression. Advanced phase treatment is aimed at re-establishing the chronic phase of CML and reducing any troublesome symptoms. There are several treatment options that may be used. The treatment of accelerated and blast phase CML usually involves a more intensive approach. These include more intensive chemotherapy using a combination of drugs similar to those used to treat acute leukaemia in combination with a different TKI. […] A stem cell transplant is now generally only used for people in whom the CML has not responded to TKIs, or who were diagnosed in the accelerated phase. Some patients may benefit by participating in a clinical trial.

• #95 Chronic myeloid leukaemia treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/chronic-myeloid-leukaemia/treatment/

  Chronic myeloid leukaemia treatment […] How is CML treated? The treatment chosen for your CML largely depends on the phase of your disease, your age and general health. Most people with CML will be treated with drugs called tyrosine kinase inhibitors (TKIs). TKIs work by blocking the activity of an enzyme called bcr-abl and thereby preventing the growth and proliferation of the leukaemic cells. The most common decision to be made at diagnosis is which of the available TKI drugs is most suited to you. This varies from person to person and your doctor will examine all the information about you that is available to them to decide on the most suitable option. […] While these drugs are very effective at controlling the disease, most people are required to take these medications for life to keep the disease under control. Only a minority of patients may be ‘cured’ by TKI therapy and are able to safely stop taking them. People with well-controlled CML are expected to have a normal life expectancy. […] In a very small number of patients, a stem cell transplant from a matched donor may be considered. This is only considered in patients who do not respond well to TKI therapy and have progressive CML. This treatment, although offering the prospect of a cure, carries serious risks. […] While you are in the chronic phase of CML, treatment is aimed at controlling your disease, prolonging this phase and delaying the onset of symptoms and complications for as long as possible. When you are first diagnosed with CML it can take one to two weeks to start therapy with a TKI. […] Adherence, also commonly called compliance, to treatment with TKIs for CML is very important for the drugs to work effectively. If there is not enough drug in the body (due to skipped doses), it is possible that the CML cells may become resistant via a process called mutation. Some mutations do not respond well to TKIs, therefore it is very important to take your medication as directed and do not make any changes without discussing it first with your haematologist. […] Although uncommon, some people already have advanced disease at diagnosis, while others may experience disease progression. Advanced phase treatment is aimed at re-establishing the chronic phase of CML and reducing any troublesome symptoms. There are several treatment options that may be used. The treatment of accelerated and blast phase CML usually involves a more intensive approach. These include more intensive chemotherapy using a combination of drugs similar to those used to treat acute leukaemia in combination with a different TKI. […] A stem cell transplant is now generally only used for people in whom the CML has not responded to TKIs, or who were diagnosed in the accelerated phase. Some patients may benefit by participating in a clinical trial.

• #96 Treating Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html

  If youve been diagnosed with chronic myeloid leukemia (CML), your treatment team will discuss your options with you. Its important to weigh the benefits of each treatment option against the possible risks and side effects. […] Targeted therapy drugs are the main treatment for chronic myeloid leukemia (CML), but some patients might also need other treatments. […] Treatment options for people with chronic myeloid leukemia (CML) depend on the phase of their disease (chronic, accelerated, or blast phase), their age, other prognostic factors, and the availability of a stem cell donor with matching tissue type. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment.

• #97 Treating Chronic Myeloid Leukemia | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-myeloid-leukemia/treating.html

  If youve been diagnosed with chronic myeloid leukemia (CML), your treatment team will discuss your options with you. Its important to weigh the benefits of each treatment option against the possible risks and side effects. […] Targeted therapy drugs are the main treatment for chronic myeloid leukemia (CML), but some patients might also need other treatments. […] Treatment options for people with chronic myeloid leukemia (CML) depend on the phase of their disease (chronic, accelerated, or blast phase), their age, other prognostic factors, and the availability of a stem cell donor with matching tissue type. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment.

• #98 Chronic Myeloid Leukemia (CML): Treatment Choices | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/chronic-myeloid-leukemia-cml-treatment-choices

  Chemotherapy uses strong medicines to kill cancer cells. It’s not a common treatment for CML. […] Radiation therapy uses strong X-rays to kill cancer cells. It can be used to kill leukemia cells that have spread to an organ, such as your spleen. […] A splenectomy is surgery to take out your spleen. Your spleen may be removed to improve your blood cell counts or to reduce pressure on other organs caused by a swollen spleen. Still, this surgery is not often used for CML. […] Researchers are always finding new ways to treat CML. These new methods are tested in clinical trials.

• #99 Chronic Myeloid Leukemia (CML): Treatment Choices | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/chronic-myeloid-leukemia-cml-treatment-choices

  Chemotherapy uses strong medicines to kill cancer cells. It’s not a common treatment for CML. […] Radiation therapy uses strong X-rays to kill cancer cells. It can be used to kill leukemia cells that have spread to an organ, such as your spleen. […] A splenectomy is surgery to take out your spleen. Your spleen may be removed to improve your blood cell counts or to reduce pressure on other organs caused by a swollen spleen. Still, this surgery is not often used for CML. […] Researchers are always finding new ways to treat CML. These new methods are tested in clinical trials.

• #100 Treatment for Chronic Myeloid Leukemia (CML) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/leukemias/treatment/chronic-myeloid-leukemia

  Patients may also receive transfusions of blood or blood products to relieve symptoms. […] If your disease is in the blast phase, treatment is likely to include chemotherapy in addition to imatinib, dasatinib, or nilotinib. […] This is a difficult phase of the disease to treat. […] Often, stem cell transplantation is recommended if an appropriate donor is available and you are healthy enough to undergo the procedure. […] Because the best results with stem cell transplantation occur when CML is in the chronic or early accelerated phase, the goal of treatment during the blast phase is to first get the patient back to an earlier phase of the disease before transplantation takes place. […] Researchers are studying the most-effective ways to use the targeted therapies that are now available (imatinib, dasatinib, and nilotinib).

• #101 Treatment for Chronic Myeloid Leukemia (CML) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/leukemias/treatment/chronic-myeloid-leukemia

  This includes determining the best timing and dosage. […] We are also working to create and test additional therapies that will block variants of the mutated BCR/ABL gene. […] After a stem cell transplantation for CML, some patients experience a recurrence of the disease. […] A strategy developed here at MSK and at other institutions a reinfusion of a particular type of white blood cell called lymphocytes from the original stem cell donor may boost these patients ability to fight the disease. […] The effectiveness of this approach is now under study.

• #102 Management of chronic myeloid leukemia in 2023 – common ground and common sense | Blood Cancer Journal

  https://www.nature.com/articles/s41408-023-00823-9

  For patients with true resistance to second-generation TKIs or with the T315I gatekeeper mutation, the third-generation TKIs are preferred. […] Ponatinib should be considered first because of the cumulative experience and results in the CML subsets, including in T315I-mutated CML. […] Asciminib is a third-generation TKI with possibly a better toxicity profile, but lesser activity in T315I-mutated CML. […] Olverembatinib is another potent third-generation TKI with early promising results. […] The primary aim of CML therapy is to improve survival so that it matches that of a normal population. […] A second aim, emphasized in the past decade but that benefits fewer patients, is the achievement of a durable deep molecular response (DMR), which can then allow treatment discontinuation and potentially a treatment-free remission (TFR) status.

• #103 Chronic Myeloid Leukaemia – Choice of Therapy and Future Perspectives

  https://touchoncology.com/haematological-malignancies/journal-articles/chronic-myeloid-leukaemia-the-choice-of-therapy-and-future-perspectives/

  Long-term TKI treatment leads to a gradual reduction of residual disease in the majority of patients and in some patients no residual disease is detectable with real-time quantitative (RQ)-PCR. […] In conclusion, according to these results, it seems obvious that patients need to be regularly monitored even years after stopping treatment. […] Recent progress in CML stem cell biology has identified several main molecules and signalling pathways that are involved in the maintenance of CML stem cells, offering possibilities for exploring new therapies for this disease.

• #104 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  There are many treatment choices for chronic myeloid leukemia (CML). Which one may work best for you? It depends on a number of factors. These include: […] Your healthcare provider is the best person to answer your questions. They can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. A certain treatment might be advised. Or more than one treatment choice may be offered, and you’ll need to decide which one is best for you. It can be hard to make this decision. You may want to consider a second opinion. It may be helpful to involve a close friend or trusted family member. […] Targeted therapy. These are medicines that focus on abnormal proteins on the leukemia (cancer) cells, such as those caused by the Philadelphia chromosome. Targeted therapy works best in treating early stages of CML. They’re often the first treatment used. They block an abnormal protein found in CML cells. Targeted therapy can work for a long time. But it doesn’t often cure CML. Medicines called tyrosine kinase inhibitors (TKIs) are standard treatment for CML.

• #105 Chronic Myeloid Leukemia (CML): Treatment Choices

  https://healthlibrary.brighamandwomens.org/Conditions/Cancer/Specific/LeukemiaCML/34,BCMLT2

  There are many treatment choices for chronic myeloid leukemia (CML). Which one may work best for you? It depends on a number of factors. These include: […] Your healthcare provider is the best person to answer your questions. They can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. A certain treatment might be advised. Or more than one treatment choice may be offered, and you’ll need to decide which one is best for you. It can be hard to make this decision. You may want to consider a second opinion. It may be helpful to involve a close friend or trusted family member. […] Targeted therapy. These are medicines that focus on abnormal proteins on the leukemia (cancer) cells, such as those caused by the Philadelphia chromosome. Targeted therapy works best in treating early stages of CML. They’re often the first treatment used. They block an abnormal protein found in CML cells. Targeted therapy can work for a long time. But it doesn’t often cure CML. Medicines called tyrosine kinase inhibitors (TKIs) are standard treatment for CML.

• #106 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422

  A bone marrow transplant, also called a stem cell transplant, is the only treatment that can cure chronic myelogenous leukemia. However, it’s usually reserved for people who haven’t been helped by other treatments. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy medicines are sometimes combined with targeted therapy to treat aggressive chronic myelogenous leukemia. […] Clinical trials are studies of new treatments. These studies provide a chance to try the latest treatments. The risk of side effects might not be known. Ask your health care provider if you might be able to be in a clinical trial.

• #107 Chronic myelogenous leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-myelogenous-leukemia/diagnosis-treatment/drc-20352422

  A bone marrow transplant, also called a stem cell transplant, is the only treatment that can cure chronic myelogenous leukemia. However, it’s usually reserved for people who haven’t been helped by other treatments. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy medicines are sometimes combined with targeted therapy to treat aggressive chronic myelogenous leukemia. […] Clinical trials are studies of new treatments. These studies provide a chance to try the latest treatments. The risk of side effects might not be known. Ask your health care provider if you might be able to be in a clinical trial.

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