Copland, M. (2022) Treatment of blast phase chronic myeloid leukaemia: a rare and challenging entity. British Journal of Haematology, 199(5), pp. 665-678. (doi: 10.1111/bjh.18370) (PMID:35866251)
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Abstract
Despite the success of BCR-ABL-specific tyrosine kinase inhibitors (TKIs) such as imatinib in chronic phase (CP) chronic myeloid leukaemia (CML), patients with blast phase (BP)-CML continue to have a dismal outcome with median survival of less than one year from diagnosis. Thus BP-CML remains a critical unmet clinical need in the management of CML. Our understanding of the biology of BP-CML continues to grow; genomic instability leads to acquisition of mutations which drive leukaemic progenitor cells to develop self-renewal properties, resulting in differentiation block and a poor-prognosis acute leukaemia which may be myeloid, lymphoid or bi-phenotypic. Similar advances in therapy are urgently needed to improve patient outcomes; however, this is challenging given the rarity and heterogeneity of BP-CML, leading to difficulty in designing and recruiting to prospective clinical trials. This review will explore the treatment of BP-CML, evaluating the data for TKI therapy alone, combinations with intensive chemotherapy, the role of allogeneic haemopoietic stem cell transplantation, the use of novel agents and clinical trials, as well as discussing the most appropriate methods for diagnosing BP and assessing response to therapy, and factors predicting outcome.
| Item Type: | Articles |
|---|---|
| Keywords: | blast phase chronic myeloid leukaemia, tyrosine kinase inhibitors, allogeneic, stem cell transplantation, combination therapy, clinical trials. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Copland, Professor Mhairi |
| Authors: | Copland, M. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
| Journal Name: | British Journal of Haematology |
| Publisher: | Wiley |
| ISSN: | 0007-1048 |
| ISSN (Online): | 1365-2141 |
| Published Online: | 22 July 2022 |
| Copyright Holders: | Copyright © 2022 The Author |
| First Published: | First published in British Journal of Haematology 199(5): 665-678 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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