Optimal Therapy for Chronic Myeloid Leukemia Blast Crisis: Current Concepts

The past 4 decades have seen the emergence of multi-agent chemotherapy, intensive AML-type induction therapy, stem cell transplantation, and novel tyrosine kinase inhibitors as potential treatment for chronic myeloid leukemia blast crisis (CML-BC). With the possible exception of allogeneic transplantation in a selected number of patients, none of these treatment strategies have impacted substantially on the dismal survival of CML-BC to date. This article will review the lessons learned from 4 decades of clinical trials in CML-BC and make recommendations for future research directions.