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2025 European LeukemiaNet recommendations for the management of chronic myeloid leukemia

Apperley, Jane F. ; Milojkovic, Dragana ; Cross, Nicholas C.P. ; Hjorth-Hansen, Henrik ; Hochhaus, Andreas ; Kantarjian, Hagop ; Lipton, Jeffrey H. ; Malhotra, Hemant ; Niederwieser, Dietger and Radich, Jerald , et al. (2025) In Leukemia 39(8). p.1797-1813
Abstract

In this 5th version of the European LeukemiaNet guidance for adult patients, there are important changes in several areas of management based on evidence available since 2020, including the World Health Organisation’s reclassification of CML as a biphasic disease. Previous advice to switch the tyrosine kinase inhibitor (TKI) on failure of molecular milestones, is modified to better account for individual patient circumstances. Our recommendations are summarized in tables designed to be read in conjunction with the text which offers justification and additional advice. We describe decision-making for first-line treatment, both in available drugs and their initial dosing. Similarly we elaborate on dose reduction rather than drug switching... (More)

In this 5th version of the European LeukemiaNet guidance for adult patients, there are important changes in several areas of management based on evidence available since 2020, including the World Health Organisation’s reclassification of CML as a biphasic disease. Previous advice to switch the tyrosine kinase inhibitor (TKI) on failure of molecular milestones, is modified to better account for individual patient circumstances. Our recommendations are summarized in tables designed to be read in conjunction with the text which offers justification and additional advice. We describe decision-making for first-line treatment, both in available drugs and their initial dosing. Similarly we elaborate on dose reduction rather than drug switching to manage toxicities and discuss treatment sequencing. Data have matured for the outcome of treatment discontinuation and for management of parenting for both men and women. We acknowledge that most patients will remain on treatment for many years and emphasize the needs to minimize side effects, manage co-morbidities and optimize quality of life. Recent advances in allogeneic stem cell transplantation have broadened access to alternative donors, and lessened limitations of age and co-morbidities such that transplant remains a valuable option for patients for whom long-term disease control is not achieved through TKI therapy.

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organization
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type
Contribution to journal
publication status
published
subject
in
Leukemia
volume
39
issue
8
pages
17 pages
publisher
Nature Publishing Group
external identifiers
  • pmid:40646132
  • scopus:105010656881
ISSN
0887-6924
DOI
10.1038/s41375-025-02664-w
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2025.
id
87c0a694-9a0d-4e86-99c9-a6408e2ca29f
date added to LUP
2025-12-12 14:41:44
date last changed
2025-12-13 03:00:04
@article{87c0a694-9a0d-4e86-99c9-a6408e2ca29f,
  abstract     = {{<p>In this 5th version of the European LeukemiaNet guidance for adult patients, there are important changes in several areas of management based on evidence available since 2020, including the World Health Organisation’s reclassification of CML as a biphasic disease. Previous advice to switch the tyrosine kinase inhibitor (TKI) on failure of molecular milestones, is modified to better account for individual patient circumstances. Our recommendations are summarized in tables designed to be read in conjunction with the text which offers justification and additional advice. We describe decision-making for first-line treatment, both in available drugs and their initial dosing. Similarly we elaborate on dose reduction rather than drug switching to manage toxicities and discuss treatment sequencing. Data have matured for the outcome of treatment discontinuation and for management of parenting for both men and women. We acknowledge that most patients will remain on treatment for many years and emphasize the needs to minimize side effects, manage co-morbidities and optimize quality of life. Recent advances in allogeneic stem cell transplantation have broadened access to alternative donors, and lessened limitations of age and co-morbidities such that transplant remains a valuable option for patients for whom long-term disease control is not achieved through TKI therapy.</p>}},
  author       = {{Apperley, Jane F. and Milojkovic, Dragana and Cross, Nicholas C.P. and Hjorth-Hansen, Henrik and Hochhaus, Andreas and Kantarjian, Hagop and Lipton, Jeffrey H. and Malhotra, Hemant and Niederwieser, Dietger and Radich, Jerald and Rousselot, Philippe and Saussele, Susanne and Schiffer, Charles A. and Silver, Richard and Soverini, Simona and Stenke, Leif and Turkina, Anna and Casado, Luis Felipe and Castagnetti, Fausto and Cervantes, Francisco and Clark, Richard E. and Cortes, Jorge and Deininger, Michael and Hughes, Timothy P. and Janssen, Jeroen and Jiang, Qian and Kim, Dong Wook and Larson, Richard A. and Mahon, Francois X. and Mauro, Michael and Mayer, Jiri and Nicolini, Franck E. and Pane, Fabrizio and Rea, Delphine and Richter, Johan and Rosti, Gianantonio and Saglio, Giuseppe and Hehlmann, Rüdiger}},
  issn         = {{0887-6924}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1797--1813}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Leukemia}},
  title        = {{2025 European LeukemiaNet recommendations for the management of chronic myeloid leukemia}},
  url          = {{http://dx.doi.org/10.1038/s41375-025-02664-w}},
  doi          = {{10.1038/s41375-025-02664-w}},
  volume       = {{39}},
  year         = {{2025}},
}