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Related Experiment Video

Updated: Apr 7, 2026

Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
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Chronic Myeloid Leukemia: A Review.

Elias Jabbour1, Hagop Kantarjian1

  • 1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston.

JAMA
|March 17, 2025
PubMed
Summary

Tyrosine kinase inhibitors (TKIs) have significantly improved survival for chronic myeloid leukemia (CML) patients, offering outcomes similar to the general population. Careful TKI selection and adherence are crucial for managing CML effectively.

Area of Science:

  • Hematology
  • Oncology
  • Molecular Biology

Background:

  • Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the Philadelphia chromosome and the BCR::ABL1 oncogene.
  • CML affects approximately 150,000 people in the US and 5 million worldwide, with an annual incidence of 2 cases per 100,000.
  • Patients typically present in the chronic phase (90%), with a rarer blastic phase (1-2%).

Purpose of the Study:

  • To review the current landscape of CML treatment with tyrosine kinase inhibitors (TKIs).
  • To highlight the impact of TKIs on patient survival and treatment selection.
  • To emphasize the importance of medication adherence and managing adverse effects.

Main Methods:

  • Review of current literature on CML pathogenesis, treatment, and outcomes.

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  • Analysis of TKI efficacy, adverse effects, and treatment guidelines.
  • Examination of the role of allogeneic hematopoietic stem cell transplant.

    • Main Results:

    • Since 2000, TKIs have reduced CML-related mortality from 10-20% annually to 1-2%, achieving survival rates comparable to age-matched populations.
    • Six BCR::ABL1 TKIs are FDA-approved, with five for first-line treatment and five for disease progression.
    • Second- and third-generation TKIs offer improved BCR::ABL1 clearance, but all TKIs have associated toxicities requiring careful consideration.

    Conclusions:

    • TKIs have revolutionized CML management, offering significantly improved survival.
    • Continuous TKI therapy is often necessary, making careful selection based on adverse effects and maximizing patient adherence critical.
    • Allogeneic stem cell transplant remains an option for refractory or intolerant patients.