Management of Chronic Myeloid Leukemia in Adults and Children

Chronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasm characterized by presence of the BCR::ABL1 fusion gene. The introduction of tyrosine kinase inhibitors (TKIs) has revolutionized CML management, leading to a dramatic improvement in overall survival and transforming CML into a chronic, manageable condition for most patients. Recent advances have focused on achieving deeper molecular responses and enabling treatment-free remission (TFR), which is now a key therapeutic goal. Novel agents and combination strategies continue to be explored to overcome resistance and improve long-term outcomes. However, the management of CML during pregnancy and in pediatric populations presents unique challenges, with limited prospective data and a lack of standardized guidelines. This chapter reviews the evolving landscape of CML therapy across adult and pediatric populations, highlighting recent developments, clinical decision-making strategies, and areas in need of further research.