Accelerated and blastic phases of chronic myelogenous leukemia.
Chronic myelogenous leukemia (CML) may have a biphasic or triphasic course, whereby patients who were initially diagnosed in the chronic phase (CP) develop more aggressive disease, frequently pass through an intermediate or accelerated phase (AP), and finally evolve into an acute leukemia like blastic phase (BP). A slowing in the rate of development of AP or BP has accompanied successive improvements in therapy for patients who have CP CML. Variable diagnostic criteria for AP and BP are used in the literature, rendering comparisons difficult. The management of patients in AP or BP consistently has been less effective than the management of those inCP for all modalities of therapy. This article reviews the current diagnostic criteria, therapeutic strategies, outcomes, and investigational therapies for AP and BP CML.
Giles
Francis J
FJ
Department of Leukemia, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 428 Houston, TX 77030, USA. fgiles@mdanderson.org
Cortes
Jorge E
JE
Kantarjian
Hagop M
HM
O'Brien
Susan M
SM
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001752:Blast Crisis / Q000175:diagnosis / Q000188:drug therapy; D002999:Clone Cells / Q000473:pathology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000473:pathology*; D015465:Leukemia, Myeloid, Accelerated Phase / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D000970:Antineoplastic Agents