Prognostic factors in chronic myeloid leukemia: at diagnosis and for treatment-free remission

Abstract

Although chronic myeloid leukemia (CML) is defined by the sole presence of the BCR::ABL1 fusion gene—the genetic event underlying the genesis of the disease—the diversity of clinical outcomes, even in the tyrosine kinase inhibitors (TKI) era, reveals that its apparent biological homogeneity is, in fact, misleading, both between and within individuals. Increasing knowledge of biological diversity through advances in cellular analytical tools and expansion of the TKI arsenal to address this heterogeneity are key factors in the path to a better disease control and ultimately cure.

In this review, we focus on well-established and novel modifiable and non-modifiable prognostic factors of CML at diagnosis and for treatment-free remission, with particular emphasis on those that are easy to use in clinical practice. We will discuss how these factors may help shape therapeutic choices. Finally, we will highlight innovative research avenues aiming at improving prognostication of CML.