TY - CHAP M1 - Book, Section TI - Chronic Myeloid Leukemia A1 - Kantarjian, Hagop A1 - Cortes, Jorge A2 - Longo, Dan L. Y1 - 2016 N1 - T2 - Harrison's Hematology and Oncology, 3e AB - Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder. The disease is driven by the BCR-ABL1 chimeric gene product, a constitutively active tyrosine kinase, resulting from a reciprocal balanced translocation between the long arms of chromosomes 9 and 22, t(9;22) (q34;q11.2), cytogenetically detected as the Philadelphia chromosome (Ph) (Fig. 15-1). Untreated, the course of CML may be biphasic or triphasic, with an early indolent or chronic phase, followed often by an accelerated phase and a terminal blastic phase. Before the era of selective BCR-ABL1 tyrosine kinase inhibitors (TKIs), the median survival in CML was 3–7 years, and the 10-year survival rate was 30% or less. Introduced into CML therapy in 2000, TKIs have revolutionized the treatment, natural history, and prognosis of CML. Today, the estimated 10-year survival rate with imatinib mesylate, the first BCR-ABL1 TKI approved, is 85%. Allogeneic stem cell transplantation (SCT), a curative but risky treatment approach, is now offered as second- or third-line therapy after failure of TKIs. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessbiomedicalscience.mhmedical.com/content.aspx?aid=1135227203 ER -