TriangleHEALTH PROFESSIONAL · SOURCE READING
Targeted therapy with TKIs
Source: Chronic Myeloid Leukemia Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: March 13, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Context: Treatment of Blastic-Phase CML / Treatment Options for Blastic-Phase CML
Bosutinib, imatinib mesylate, dasatinib, and nilotinib have demonstrated activity in patients with myeloid blast crisis and lymphoid blast crisis or Philadelphia (Ph) chromosome–positive acute lymphoblastic leukemia (ALL).[1-3]
Evidence (targeted therapy with TKIs):
Two trials of imatinib mesylate and one trial of dasatinib involved a total of 518 patients with blastic-phase CML.[2,4,5][Level of evidence C1]
Source links and citations
Two trials of imatinib mesylate and one trial of dasatinib involved a total of 518 patients with blastic-phase CML.[2,4,5][Level of evidence C1]
The studies confirmed a hematologic response rate of 42% to 55% and a major cytogenetic response rate of 16% to 25%, but the estimated 2-year survival rate was below 28%.
Patients with lymphoid blastic-phase CML (as opposed to the more common myeloid blastic phase) have been given the same therapy as patients with Ph chromosome–positive ALL. In a phase II trial, 23 patients with lymphoid blastic-phase CML received hyper-CVAD (hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone) and dasatinib. The major molecular response rate was 70%, and most patients were referred for allogeneic SCT.[6][Level of evidence C3]
Source links and citations
A review of 477 patients with blastic-phase CML treated between 1997 and 2016 at a single center showed that 72% had received previous TKI therapy in chronic phase before transformation.[7][Level of evidence C3]
Source links and citations
A review of 477 patients with blastic-phase CML treated between 1997 and 2016 at a single center showed that 72% had received previous TKI therapy in chronic phase before transformation.[7][Level of evidence C3]
The median overall survival was 12 months.
A review of 477 patients with blastic-phase CML treated between 1997 and 2016 at a single center showed that 72% had received previous TKI therapy in chronic phase before transformation.[7][Level of evidence C3]
The median failure-free survival was 5 months.
A review of 477 patients with blastic-phase CML treated between 1997 and 2016 at a single center showed that 72% had received previous TKI therapy in chronic phase before transformation.[7][Level of evidence C3]
Patients who could complete an allogeneic SCT fared best, but this may have resulted from selection bias.
Publication references
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Preserved source evidence · Not medical advice