Allogeneic stem cell transplantation for chronic myeloid leukemia in the tyrosine kinase inhibitor era

Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm characterized by the production of mature granulocytes and their precursors that are dysregulated and uncontrolled. The presence of the Philadelphia chromosome (Ph) is the hallmark of CML; it encodes a chimeric protein with constitutive tyrosine kinase activity that leads to uncontrolled cell growth and eventually the development of CML. Tyrosine kinase inhibitors (TKI) revolutionized the management of patients with CML. Before TKIs, hematopoietic stem cell transplantation had a major role in the treatment of these patients, but currently, its use is limited to cases presenting in the advanced phase and patients in the chronic phase failing multiple TKIs. In this article, the author summarizes the data about hematopoietic stem cell transplantation use in chronic phase CML, reviews the published guidelines, and provides his opinion.