Chronic Myeloid Leukemia/Myelofibrosis: TKI Therapy and Toxicity Management

Abstract

Recent advances in the understanding of the molecular basis of chronic myeloid leukemia (CML) and myelofibrosis have led to more effective treatment options, with survival now close to that of age-matched controls in CML. The latest updates to the NCCN Guidelines for CML reflect the rapidly evolving treatment landscape, emphasizing the increasing importance of personalized medicine and various targeted therapies. For patients with CML, standard of care involves tyrosine kinase inhibitors such as imatinib, dasatinib, bosutinib, nilotinib, ponatinib, and asciminib, tailored to patient-specific factors and the severity of adverse events. In patients with myelofibrosis, the Janus kinase inhibitors ruxolitinib, pacritinib, and fedratinib have yielded improved outcomes. Critical strategies for managing treatment-related adverse events to optimize the quality of life for patients with these hematologic malignancies were also highlighted.