A Perspective on the Molecular Evolution of Chronic Myeloid Leukemia from Chronic Phase to Blast Transformation

Chronic myeloid leukemia is typically diagnosed in the Initials chronic phase and then spontaneously evolves after some years into an advanced phase, which can sometimes be subdivided into an earlier accelerated phase and a later blast transformation. It is remarkable that though much is now known about the molecular events that initiate the disease, the precise molecular basis of disease progression remains an enigma. It is generally assumed that one or more, probably a sequence of additional genetic events, occurs in the Bcr-Abl–positive clone. When the critical combination of additional events is achieved, clinically recognizable transformation occurs. In this article, we review the possible molecular mechanisms underlying the evolution of chronic myeloid leukemia from a chronic phase to blastic transformation.