Annals of Hematology

, Volume 94, Supplement 2, pp 141–147 | Cite as

A review of the European LeukemiaNet recommendations for the management of CML

  • Michele Baccarani
  • Fausto Castagnetti
  • Gabriele Gugliotta
  • Gianantonio Rosti
Review Article


Several guidelines and recommendations on the management of chronic myeloid leukemia (CML) have been prepared by several scientific societies. The European LeukemiaNet (ELN) appointed a panel of experts who submitted their recommendations to peer-reviewed scientific journals in 2006, 2009, and 2013. Here, we make a critical review of the last, 2013, ELN recommendations, concerning the use of the five available tyrosine kinase inhibitors (TKIs), the evaluation of cytogenetic and molecular response, and the strategy of treatment. Three TKIs (imatinib, nilotinib, dasatinib) are recommended first-line. Bosutinib and ponatinib are available second-line; ponatinib is particularly indicated in case of the T315I mutation. Achieving an optimal response, not only for survival but also for a deeper, stable, treatment-free remission, requires a BCR-ABL transcripts level ≤10 % at 3 months, ≤1 % at 6 months, ≤0.1 % at 1 year, and ≤0.01 % later on. Molecular monitoring must include mutational analysis in every case of failure. A successful treatment of accelerated and blastic phase requires TKIs, and in many cases also allogeneic stem cell transplantation.


Chronic myeloid leukemia Tyrosine kinase inhibitors BCR-ABL1 Philadelphia chromosome 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Michele Baccarani
    • 1
  • Fausto Castagnetti
    • 1
    • 2
  • Gabriele Gugliotta
    • 1
    • 2
  • Gianantonio Rosti
    • 1
    • 2
    • 3
  1. 1.Department of Hematology and Oncology “L. and A. Seràgnoli”University of Bologna, S. Orsola-Malpighi University HospitalBolognaItaly
  2. 2.Department of Experimental, Diagnostic and Specialty MedicineUniversity of Bologna, S. Orsola-Malpighi University HospitalBolognaItaly
  3. 3.Institute of Hematology “L. and A. Seràgnoli”S.Orsola-Malpighi University HospitalBolognaItaly

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