What are treatment protocols for blast-phase chronic myelogenous leukemia (BP-CML)?

Updated: Oct 23, 2019
  • Author: Rossa Khalaf, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Initial presentation with BP-CML is rare. Allogeneic HCT is recommended as the first-line treatment in these cases. However, patients who progressn to BP-CML while on TKI therapy, should be switched to an alternate TKI as a bridge therapy before allogeneic HCT.

TKI along with induction chemo therapy are indicated. AML induction therapy to be used when myeloid BP-CML and ALL induction therapy is recommended in lymphoid BP-CML.

CNS prophylaxis is recommended for lymphoid type, as CNS involvement was reported. [30]

The risk of relapse is high. Treatment options include donor lymphocyte infusion (DLI); imatinib, in patients who did not fail imatinib initially; or DLI along with imatinib.

Dasatinib may be effective for treatment of extramedullary relapse following transplantation. [31]


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