Treatment regimens in the phases of CML

Treatments for patients with CML include

  • Targeted therapy (i.e., TKIs)
  • Chemotherapy
  • ASCT
  • Combinations of the above treatments

The treatment selected for patients depends on which CML phase they are in:

Chronic phase:

  • Main treatment in this phase is any of the five TKIs (imatinib, nilotinib, dasatinib, bosutinib and ponatinib).
  • The European Medicines Agency (EMA) has approved these drugs in the UK. They are also recommended by the National Institute for Health and Care Excellence (NICE).

Accelerated phase:

  • Initial treatment is one of the newer generation TKIs such as dasatinib or ponatinib to reduce the symptoms of CML.

Follow-up treatment is an early ASCT if possible.

Blast phase:

  • Treatment with the TKI ponatinib combined with chemotherapy, followed by an ASCT following complete response.