Management of CML-blast crisis

Best Pract Res Clin Haematol. 2016 Sep;29(3):295-307. doi: 10.1016/j.beha.2016.10.005. Epub 2016 Oct 20.

Abstract

Tyrosine kinase inhibitors (TKI) have moderately improved survival in BC, but a median survival of less than 1 year is still unsatisfactory. This article reviews the various tests required for diagnosis of BC, features at diagnosis, treatment modalities (intensive chemotherapy, TKI, allo-SCT and a selection of investigational agents), options of prevention and predictors of progression. The best prognosis is observed in patients that achieve a 2nd CP. Allo-SCT probably further improves prognosis of patients in 2nd CP. The choice of TKI should be directed by the mutation profile of the patient. BC can be prevented. A careful analysis of risk factors for progression may help. Current treatment options are combined in a concluding strategy for the management of BC.

Keywords: CML blast crisis; Diagnosis; Early prediction; Prevention; Therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allografts
  • Blast Crisis* / diagnosis
  • Blast Crisis* / enzymology
  • Blast Crisis* / genetics
  • Blast Crisis* / therapy
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / enzymology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / genetics
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / therapy
  • Mutation*
  • Prognosis
  • Protein Kinase Inhibitors / therapeutic use*
  • Stem Cell Transplantation*

Substances

  • Protein Kinase Inhibitors