Chronic Myeloid Leukemia (BCR-ABL1)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-CML |
|---|---|
| Type | Disease |
| Aliases | CMLChronic Myeloid LeukemiaChronic myelogenous leukemiaPh+ CMLХронічна мієлоїдна лейкемія (BCR-ABL1)Хронічний мієлолейкоз |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-ELN-CML-2020 SRC-ESMO-CML-2017 SRC-NCCN-MPN-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 9863/3 |
|---|---|
| icd_o_3_topography | ["C42.1"] |
| icd_10 | C92.1 |
| who_classification | Chronic myeloid leukaemia, BCR::ABL1-positive (per WHO 5th ed.) — chronic, accelerated, blast phase |
Notes
Etiologically-driven archetype (single causal driver: BCR-ABL1). TKI choice in chronic phase 1L is the central question, driven by ELTS risk + comorbidity matrix: imatinib for low-risk / elderly / cost-constrained; nilotinib or dasatinib or bosutinib for higher-risk young targeting deep molecular response + treatment-free remission; ponatinib / asciminib reserved for T315I or ≥3L. Response milestones by IS BCR-ABL1: ≤10% at 3 mo, ≤1% at 6 mo, ≤0.1% (MMR) at 12 mo. STUB — requires clinical co-lead signoff before publication. Myeloid expansion (heme).
Used By
Actionability
BMA-BCR-ABL1-E255K-CML- BCR-ABL1 E255K/V is a P-loop mutation conferring strong resistance to imatinib and reduce...BMA-BCR-ABL1-F317L-CML- BCR-ABL1 F317L confers resistance to dasatinib but retains sensitivity to nilotinib, bosu...BMA-BCR-ABL1-P210-CML- BCR-ABL1 p210 (e13a2/e14a2) defines chronic-phase CML and is the paradigm targeted-therap...BMA-BCR-ABL1-T315I-CML- BCR-ABL1 T315I is the gatekeeper mutation conferring pan-resistance to imatinib, dasatini...BMA-BCR-ABL1-V299L-CML- BCR-ABL1 V299L confers resistance to dasatinib and bosutinib but retains sensitivity to n...
Algorithms
ALGO-CML-1L- ALGO-CML-1LALGO-CML-2L- ALGO-CML-2L
Indication
IND-CML-1L-2GEN-TKI- IND-CML-1L-2GEN-TKIIND-CML-1L-IMATINIB- IND-CML-1L-IMATINIBIND-CML-2L-PONATINIB-T315I- IND-CML-2L-PONATINIB-T315IIND-CML-3L-ASCIMINIB- IND-CML-3L-ASCIMINIBIND-CML-ADVANCED-ALLOHCT- IND-CML-ADVANCED-ALLOHCT
Questionnaires
QUEST-CML-1L-STUB- Chronic Myeloid Leukemia — first line
Red flag
RF-CML-COMORBIDITY-COMPLEX- CML patient with cardiovascular / metabolic / pulmonary comorbidity profile that constrai...RF-CML-FRAILTY-AGE- CML patient elderly or frail (age ≥75, ECOG ≥2 with multiple comorbidities) where toxicit...RF-CML-HIGH-RISK-ELTS- CML high-risk by ELTS (EUTOS Long-Term Survival score) — favors 2nd-generation TKI (nilot...RF-CML-INFECTION-SCREENING- CML patient with positive HBV serology (HBsAg+ or anti-HBc+) — TKI therapy is associated...RF-CML-ORGAN-DYSFUNCTION- CML patient with comorbidity excluding specific 2nd-gen TKIs: significant cardiovascular...RF-CML-T315I-MUTATION- CML with T315I gatekeeper mutation in the BCR-ABL1 kinase domain — resistant to all 1st/2...RF-CML-TRANSFORMATION-PROGRESSION- CML in accelerated or blast phase: ≥10% blasts in PB or BM (accelerated), ≥20% blasts (bl...RF-HASFORD-HIGH- CML chronic phase with Hasford (EURO) high risk — supports 2nd-generation TKI 1L (dasatin...RF-SOKAL-HIGH- CML chronic phase with Sokal high risk — supports 2nd-generation TKI 1L (dasatinib / nilo...
Sources
SRC-ASCEMBL-REA-2021- Asciminib in Chronic Myeloid Leukemia after ABL Kinase Inhibitor FailureSRC-ELN-CML-2020- European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemiaSRC-ELN-CML-2025- 2025 European LeukemiaNet recommendations for the management of chronic myeloid leukemiaSRC-ESMO-CML-2017- Chronic myeloid leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and...SRC-IRIS-OBRIEN-2003- Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-pha...SRC-PACE-CORTES-2013- A phase 2 trial of ponatinib in Philadelphia chromosome-positive leukemias