Radich Figure 9 (in Druker et al). A possible modern treatment algorithm for CML.

Patients with a related or unrelated donor could be considered for early transplantation. Young patients could be offered a full allogeneic transplant for any phase from a related or unrelated doror (green rectangle, where the width of the rectangle suggests the enthusiasm for transplant). “Middle age” patients (tactfully defined) are offered transplantation with diminished enthusiasm for advanced disease; elderly patients are offered a nonmyeloablative transplant (blue arrow). Patients with a donor can be tried on imatinib, but sent to transplant if they do not obtain a complete cytogenetic response (CCR), or if they do achieve a CCR, show molecular evidence of progression. Patients without a donor can receive imatinib. If they do not respond, investigation therapy with an autologous transplant can be considered (grey arrow). If they do obtain a CCR, stem cell storage can be considered.