J Natl Compr Canc Netw. 2014 Nov;12(11):1590-610. doi: 10.6004/jnccn.2014.0159.
Chronic myelogenous leukemia (CML) is usually diagnosed in the chronic phase. Untreated chronic phase CML will eventually progress to advanced phase (accelerated or blast phase) CML. Tyrosine kinase inhibitors (TKIs) have been shown to induce favorable response rates in patients with accelerated and blast phase CML. The addition of TKIs to chemotherapy has also been associated with improved outcomes in patients with blast phase CML. Allogeneic hematopoietic stem cell transplant remains a potentially curative option for patients with advanced phase CML, although treatment with a course of TKIs will be beneficial as a bridge to transplant. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with advanced phase CML.
慢性髓性白血病(CML)通常在慢性期被诊断。未经治疗的慢性期 CML 最终将进展为加速期或急变期 CML。酪氨酸激酶抑制剂(TKI)已被证明可诱导加速期和急变期 CML 患者产生良好的反应率。将 TKI 加用至化疗也与急变期 CML 患者的改善结局相关。异基因造血干细胞移植仍然是晚期 CML 患者的一种潜在治愈选择,尽管用 TKI 治疗作为移植的桥梁是有益的。本文讨论了 NCCN 指南中概述的用于诊断和管理晚期 CML 患者的建议。