title: Management of CML-blast crisis.
abstract: Tyrosine kinase inhibitors (TKI) have moderately improved survival in BC, but a median survival of less than 1 year is still unsatisfactory. This article reviews the various tests required for diagnosis of BC, features at diagnosis, treatment modalities (intensive chemotherapy, TKI, allo-SCT and a selection of investigational agents), options of prevention and predictors of progression. The best prognosis is observed in patients that achieve a 2nd CP. Allo-SCT probably further improves prognosis of patients in 2nd CP. The choice of TKI should be directed by the mutation profile of the patient. BC can be prevented. A careful analysis of risk factors for progression may help. Current treatment options are combined in a concluding strategy for the management of BC.
authors.affiliation: Medizinische Fakultät Mannheim, Universität Heidelberg, III. Medizinische Klinik, Pettenkoferstr. 22, 68169 Mannheim, Germany. Electronic address: Sekretariat.hehlmann@medma.uni-heidelberg.de.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hehlmann
authors.affiliation: Medizinische Fakultät Mannheim, Universität Heidelberg, III. Medizinische Klinik, Pettenkoferstr. 22, 68169 Mannheim, Germany. Electronic address: susanne.saussele@medma.uni-heidelberg.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Saußele
authors.affiliation: Medizinische Fakultät Mannheim, Universität Heidelberg, III. Medizinische Klinik, Pettenkoferstr. 22, 68169 Mannheim, Germany. Electronic address: Astghik.Voskanyan@medma.uni-heidelberg.de.
authors.forename: Astghik
authors.initials: A
authors.lastname: Voskanyan
authors.affiliation: Division of Hematology/Medical Oncology, Weill Cornell Medical College, New York, NY, USA. Electronic address: rtsilve@med.cornell.edu.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Silver
mesh_terms: D064591:Allografts; D001752:Blast Crisis / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics / Q000628:therapy; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000201:enzymology / Q000235:genetics / Q000628:therapy; D009154:Mutation; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D033581:Stem Cell Transplantation
chemical_list: D047428:Protein Kinase Inhibitors
keywords: CML blast crisis; Diagnosis; Early prediction; Prevention; Therapy