Abstract
Progression of chronic myeloid leukemia to blast crisis (CML BC) is still a phenomenon that is only incompletely understood. In up to 90% of BC patients, additional chromosomal aberrations (ACA) are reported. In up to 77% mutations are detected by means of deep genome sequencing. In gene expression profiles blast crisis appears as a disease distinct from CML. Treatment continues to be mostly unsuccessful unless allo SCT is offered. Treatment failure indicates point of no return. Additional chromosomal aberrations (ACA) are associated with CML blast crisis, being non-random in chromosomal distribution. Major route ACA are +8 (34%), +Ph (30%), i(17q) (20%), +19 (13%), +21 (7%), +17 (5%),
Highlights
Treatment of BC in CML study IV is heterogeneous as expected without specific recommendations in the study protocol
In up to 90% of BC patients, additional chromosomal aberrations (ACA) are reported
Special attention is drawn to tyrosine kinase inhibitors (TKIs, imatinib, nilotinib, dasatinib) in blast crisis
Summary
Treatment of BC in CML study IV is heterogeneous as expected without specific recommendations in the study protocol. Blast crisis, stem cell transplantation, experimental treatment. Progression of chronic myeloid leukemia to blast crisis (CML BC) is still a phenomenon that is only incompletely understood.
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