Advanced phases of Philadelphia chromosome positive (Ph+) chronic myeloid leukemia, classically encompassing de novo presentation of accelerated phase disease and blast phase disease (myeloid and lymphoid 'blast crisis') as well as progression to these from antecedent chronic phase disease, have diminished in incidence but remain a challenge. Despite continued development of additional and novel kinase inhibitors of BCR::ABL1, global limitations on access to diagnostics and therapy persist and account for continued incidence of advanced disease at initial presentation as well as progressive disease. Evolution in defining risk through clinical and molecular characterization should increase ability to identify emerging advanced disease, minimize progression and improve treatment of resistant chronic phase and blast phase disease. While BCR::ABL1 tyrosine kinase inhibition remains central in advanced disease, combination therapy with conventional and novel chemotherapy, immunotherapy, and allogeneic stem cell transplantation provide best long-term outcomes.
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Review Article|
December 2, 2025
How I Treat Advanced Phases of CML Available to Purchase
Michael J. Mauro
Memorial Sloan Kettering Cancer Center, New York, New York, United States
* Corresponding Author; email: maurom@mskcc.org
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Blood blood.2024026510.
Article history
Submitted:
June 16, 2025
Revision Received:
September 9, 2025
Accepted:
September 26, 2025
Citation
Michael J. Mauro; How I Treat Advanced Phases of CML. Blood 2025; blood.2024026510. doi: https://doi.org/10.1182/blood.2024026510
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