The only known potential cure for Chronic Myeloid Leukemia (CML) is allogeneic stem cell transplantation (SCT).
While tyrosine kinase inhibitors (TKIs) have dramatically improved the management of CML, providing excellent disease control and allowing many patients to live near-normal lives, they are generally not considered curative. Patients typically need to remain on TKI therapy indefinitely.
Allogeneic SCT, also known as a bone marrow transplant, involves replacing the patient's own blood-forming cells with healthy cells from a donor. This procedure carries significant risks and is typically reserved for patients who:
- Are resistant or intolerant to TKI therapy.
- Have progressed to an accelerated or blast phase of CML.
- Are eligible and have a suitable donor.
However, even with SCT, the success rate varies, and the long-term survival rate, especially for patients in blast phase CML, can be less than 20%. The chances of success are higher if the CML can be returned to the chronic phase before the transplant.
In summary:
- TKIs: Manage CML effectively but are typically not curative.
- Allogeneic SCT: Is the only known potential cure, but it carries risks and is not always successful.
