{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:55:22Z","timestamp":1792457722984,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Hematol Malig Rep"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Purpose of Review<\/jats:title>\n                <jats:p>Due to lack of pediatric-specific data, the management of chronic myeloid leukemia (CML) in pediatric, adolescents, and young adults is guided by adult CML evidence-based recommendations. Pediatric CML presents differently than adult CML and is often a more aggressive disease with different biological and host factors, yet there is sparse literature on how to address those differences.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Recent Findings<\/jats:title>\n                <jats:p>Over the past two decades, tyrosine kinase inhibitors (TKIs) have changed the way CML is treated. There are currently three FDA-approved TKIs (imatinib, dasatinib, and nilotinib) for pediatric patients. When choosing which TKI to begin treatment with, there are many factors that should be considered on a case-to-case basis to obtain optimal outcomes. The safety profiles for long-term TKI use in pediatrics require further study. Unlike adults, children are still actively growing during TKI use, and the effect on development can be detrimental. TKI therapy is not recommended during pregnancy with variable but significant risk of fetal abnormalities and miscarriage, warranting counseling for young female patients prior to beginning TKIs. Attempts for treatment-free remission (TFR) by planned TKI cessation in eligible adult patients in deep and sustained molecular remission are now done as a standard of practice. However, data is sparse in the pediatric population. There is currently an ongoing Children\u2019s Oncology Group (COG) study to determine the feasibility of TFR as a treatment goal.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Summary<\/jats:title>\n                <jats:p>Further research and additional pediatric trials are needed to characterize the unique aspects of CML in children and adolescents and optimize outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11899-022-00673-5","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T14:25:13Z","timestamp":1659536713000},"page":"121-126","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Management of Chronic Myeloid Leukemia in Children and Young Adults"],"prefix":"10.1007","volume":"17","author":[{"given":"Maegan","family":"Ford","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mauro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Aftandilian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0494-8838","authenticated-orcid":false,"given":"Kathleen M.","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuko","family":"Hijiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"issue":"9","key":"673_CR1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27827","volume":"66","author":"U Athale","year":"2019","unstructured":"Athale U, Hijiya N, Patterson BC, Bergsagel J, Andolina JR, Bittencourt H, Schultz KR, Burke MJ, Redell MS, Kolb EA, Johnston DL. Management of chronic myeloid leukemia in children and adolescents: recommendations from the Children\u2019s Oncology Group CML Working Group. Pediatr Blood Cancer. 2019;66(9): e27827.","journal-title":"Pediatr Blood Cancer"},{"issue":"22","key":"673_CR2","doi-asserted-by":"publisher","first-page":"2374","DOI":"10.1182\/blood.2018882233","volume":"133","author":"N Hijiya","year":"2019","unstructured":"Hijiya N, Suttorp M. How I treat chronic myeloid leukemia in children and adolescents. Blood. 2019;133(22):2374\u201384.","journal-title":"Blood"},{"issue":"4","key":"673_CR3","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1182\/blood-2015-06-648667","volume":"127","author":"N Hijiya","year":"2016","unstructured":"Hijiya N, Schultz KR, Metzler M, Millot F, Suttorp M. Pediatric chronic myeloid leukemia is a unique disease that requires a different approach. Blood. 2016;127(4):392\u20139.","journal-title":"Blood"},{"issue":"1","key":"673_CR4","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.pcl.2014.09.008","volume":"62","author":"N Hijiya","year":"2015","unstructured":"Hijiya N, Millot F, Suttorp M. Chronic myeloid leukemia in children: clinical findings, management, and unanswered questions. Pediatr Clin North Am. 2015;62(1):107\u201319.","journal-title":"Pediatr Clin North Am"},{"issue":"3","key":"673_CR5","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/s40272-021-00446-2","volume":"23","author":"LN Phillips","year":"2021","unstructured":"Phillips LN, Hijiya N. Tyrosine kinase inhibitors and beyond for chronic myeloid leukemia in children. Paediatr Drugs. 2021;23(3):241\u201351.","journal-title":"Paediatr Drugs"},{"key":"673_CR6","unstructured":"National Comprehensive Cancer Network (NCCN) Clinical practice guidelines in oncology-chronic myeloid leukemia (ver 2, 2022); 2022."},{"issue":"4","key":"673_CR7","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1038\/s41375-020-0776-2","volume":"34","author":"A Hochhaus","year":"2020","unstructured":"Hochhaus A, Baccarani M, Silver RT, Schiffer C, Apperley JF, Cervantes F, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020;34(4):966\u201384.","journal-title":"Leukemia"},{"issue":"1","key":"673_CR8","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1093\/annonc\/mdu490","volume":"26","author":"F Castagnetti","year":"2015","unstructured":"Castagnetti F, Gugliotta G, Baccarani M, et al. Differences among young adults, adults and elderly chronic myeloid leukemia patients. Ann Oncol. 2015;26(1):185\u201392.","journal-title":"Ann Oncol"},{"issue":"15","key":"673_CR9","doi-asserted-by":"publisher","first-page":"2408","DOI":"10.1182\/blood-2014-05-578567","volume":"124","author":"F Millot","year":"2014","unstructured":"Millot F, Guilhot J, Baruchel A, et al. Impact of early molecular response in children with chronic myeloid leukemia treated in the French Glivec phase 4 study. Blood. 2014;124(15):2408\u201310.","journal-title":"Blood"},{"issue":"18","key":"673_CR10","doi-asserted-by":"publisher","first-page":"3609","DOI":"10.1002\/cncr.30767","volume":"123","author":"F Millot","year":"2017","unstructured":"Millot F, Dupraz C, Guilhot J, et al. Additional cytogenetic abnormalities and variant t(9;22) at the diagnosis of childhood chronic myeloid leukemia: The experience of the International Registry for Chronic Myeloid Leukemia in Children and Adolescents. Cancer. 2017;123(18):3609\u201316.","journal-title":"Cancer"},{"issue":"7","key":"673_CR11","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.3390\/cancers14071712","volume":"14","author":"A Karow","year":"2022","unstructured":"Karow A, G\u00f6hring G, Sembill S, et al. The cytogenetic landscape of pediatric chronic myeloid leukemia diagnosed in chronic phase. Cancers (Basel). 2022;14(7):1712.","journal-title":"Cancers (Basel)"},{"issue":"4","key":"673_CR12","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1007\/s12094-017-1751-x","volume":"20","author":"R de C\u00e1ssiaViu Carrara","year":"2018","unstructured":"de C\u00e1ssiaViu Carrara R, Fontes AM, Abraham KJ, et al. Expression differences of genes in the PI3K\/AKT, WNT\/b-catenin, SHH, NOTCH and MAPK signaling pathways in CD34+ hematopoietic cells obtained from chronic phase patients with chronic myeloid leukemia and from healthy controls. Clin Transl Oncol. 2018;20(4):542\u20139.","journal-title":"Clin Transl Oncol"},{"issue":"9","key":"673_CR13","doi-asserted-by":"publisher","first-page":"2046","DOI":"10.1038\/s41375-018-0157-2","volume":"32","author":"T Ernst","year":"2018","unstructured":"Ernst T, Busch M, Rinke J, et al. Frequent ASXL1 mutations in children and young adults with chronic myeloid leukemia. Leukemia. 2018;32(9):2046\u20139.","journal-title":"Leukemia"},{"issue":"24","key":"673_CR14","doi-asserted-by":"publisher","first-page":"6263","DOI":"10.3390\/cancers13246263","volume":"13","author":"M Youn","year":"2021","unstructured":"Youn M, Smith SM, Lee AG, et al. Comparison of the transcriptomic signatures in pediatric and adult CML. Cancers (Basel). 2021;13(24):6263.","journal-title":"Cancers (Basel)"},{"issue":"10","key":"673_CR15","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.3324\/haematol.2017.170035","volume":"102","author":"F Millot","year":"2017","unstructured":"Millot F, Guilhot J, Suttorp M, et al. Prognostic discrimination based on the EUTOS long-term survival score within the International Registry for Chronic Myeloid Leukemia in children and adolescents. Haematologica. 2017;102(10):1704\u20138.","journal-title":"Haematologica"},{"issue":"24","key":"673_CR16","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1056\/NEJMoa1902328","volume":"381","author":"TP Hughes","year":"2019","unstructured":"Hughes TP, Mauro MJ, Cortes JE, et al. Asciminib in chronic myeloid leukemia after ABL kinase inhibitor failure. N Engl J Med. 2019;381(24):2315\u201326.","journal-title":"N Engl J Med"},{"issue":"21","key":"673_CR17","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1182\/blood.2020009984","volume":"138","author":"D R\u00e9a","year":"2021","unstructured":"R\u00e9a D, Mauro MJ, Boquimpani C, et al. A phase 3, open-label, randomized study of asciminib, a STAMP inhibitor, vs bosutinib in CML after 2 or more prior TKIs. Blood. 2021;138(21):2031\u201341.","journal-title":"Blood"},{"issue":"Supplement 1","key":"673_CR18","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.1182\/blood-2021-145709","volume":"138","author":"E Pennesi","year":"2021","unstructured":"Pennesi E, Brivio E, Willemse ME, et al. A phase I\/II study of bosutinib in pediatric patients with resistant\/intolerant or newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia, Study ITCC (Innovative Therapies for Children with Cancer European Consortium) 054 and COG (Children\u2019s Oncology Group Consortium) AAML1921: Results from the Phase I Trial in Resistant\/Intolerant Patients. Blood. 2021;138(Supplement 1):2558\u20132558.","journal-title":"Blood"},{"key":"673_CR19","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1038\/leu.2016.5","volume":"30","author":"A Hochhaus","year":"2016","unstructured":"Hochhaus A, Saglio G, Hughes TP, et al. Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial. Leukemia. 2016;30:1044\u201354.","journal-title":"Leukemia"},{"issue":"20","key":"673_CR20","doi-asserted-by":"publisher","first-page":"2333","DOI":"10.1200\/JCO.2015.64.8899","volume":"34","author":"JE Cortes","year":"2016","unstructured":"Cortes JE, Saglio G, Kantarjian HM, et al. Final 5-year study results of DASISION: The dasatinib versus imatinib study in treatment-naive chronic myeloid leukemia patients Trial. J Clin Oncol. 2016;34(20):2333\u201340.","journal-title":"J Clin Oncol"},{"issue":"23","key":"673_CR21","doi-asserted-by":"publisher","first-page":"2036","DOI":"10.1182\/blood.2019000069","volume":"134","author":"N Hijiya","year":"2019","unstructured":"Hijiya N, Maschan A, Rizzari C, et al. Phase 2 study of nilotinib in pediatric patients with Philadelphia chromosome-positive chronic myeloid leukemia. Blood. 2019;134(23):2036\u201345.","journal-title":"Blood"},{"issue":"13","key":"673_CR22","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1200\/JCO.2017.75.9597","volume":"36","author":"L Gore","year":"2018","unstructured":"Gore L, Kearns PR, de Martino ML, et al. Dasatinib in pediatric patients with chronic myeloid leukemia in chronic phase: results from a phase II trial. J Clin Oncol. 2018;36(13):1330\u20138.","journal-title":"J Clin Oncol"},{"issue":"20","key":"673_CR23","doi-asserted-by":"publisher","first-page":"2827","DOI":"10.1200\/JCO.2010.32.7114","volume":"29","author":"F Millot","year":"2011","unstructured":"Millot F, Baruchel A, Guilhot J, et al. Imatinib is effective in children with previously untreated chronic myelogenous leukemia in early chronic phase: results of the French national phase IV trial. J Clin Oncol. 2011;29(20):2827\u201332.","journal-title":"J Clin Oncol"},{"issue":"1","key":"673_CR24","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1182\/asheducation-2017.1.110","volume":"2017","author":"MC Barber","year":"2017","unstructured":"Barber MC, Mauro MJ, Moslehi J. Cardiovascular care of patients with chronic myeloid leukemia (CML) on tyrosine kinase inhibitor (TKI) therapy. Hematology Am Soc Hematol Educ Program. 2017;2017(1):110\u20134.","journal-title":"Hematology Am Soc Hematol Educ Program"},{"issue":"22","key":"673_CR25","doi-asserted-by":"publisher","first-page":"2507","DOI":"10.1182\/blood.2020006911","volume":"136","author":"J Cortes","year":"2020","unstructured":"Cortes J. How to manage CML patients with comorbidities. Blood. 2020;136(22):2507\u201312.","journal-title":"Blood"},{"key":"673_CR26","doi-asserted-by":"crossref","unstructured":"Patterson BC, Samis J, Gore L, et al. Growth rate and endocrine effects of dasatinib therapy observed in a retrospective analysis if a phase 3 clinic trial for pediatric patients with chronic myeloid leukemia in the chronic phase (CML-CP) European Hematology Association Congress. Amsterdam, Netherlands; 2019.","DOI":"10.1097\/01.HS9.0000559876.36369.09"},{"issue":"8","key":"673_CR27","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1002\/pbc.26028","volume":"63","author":"J Samis","year":"2016","unstructured":"Samis J, Lee P, Zimmerman D, Arceci RJ, Suttorp M, Hijiya N. Recognizing endocrinopathies associated with tyrosine kinase inhibitor therapy in children with chronic myelogenous leukemia. Pediatr Blood Cancer. 2016;63(8):1332\u20138.","journal-title":"Pediatr Blood Cancer"},{"issue":"21","key":"673_CR28","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1182\/blood.V124.21.522.522","volume":"124","author":"JT Tauer","year":"2014","unstructured":"Tauer JT, Nowasz C, Sedlacek P, de Bont ESJM, Aleinikova OV, Suttorp M. Impairment of longitudinal growth by tyrosine kinase inhibitor (TKI) treatment \u2014 data from a large pediatric cohort with chronic myeloid leukemia (CML). Blood. 2014;124(21):522\u2013522.","journal-title":"Blood"},{"issue":"5S","key":"673_CR29","doi-asserted-by":"publisher","first-page":"660","DOI":"10.6004\/jnccn.2018.0035","volume":"16","author":"E Berman","year":"2018","unstructured":"Berman E. Pregnancy in patients with chronic myeloid leukemia. J Natl Compr Canc Netw. 2018;16(5S):660\u20132.","journal-title":"J Natl Compr Canc Netw"},{"issue":"Suppl 2","key":"673_CR30","doi-asserted-by":"publisher","first-page":"S167","DOI":"10.1007\/s00277-015-2317-z","volume":"94","author":"R Palani","year":"2015","unstructured":"Palani R, Milojkovic D, Apperley JF. Managing pregnancy in chronic myeloid leukaemia. Ann Hematol. 2015;94(Suppl 2):S167\u201376.","journal-title":"Ann Hematol"}],"container-title":["Current Hematologic Malignancy Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11899-022-00673-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11899-022-00673-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11899-022-00673-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T12:48:59Z","timestamp":1663850939000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11899-022-00673-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,3]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["673"],"URL":"https:\/\/doi.org\/10.1007\/s11899-022-00673-5","relation":{},"ISSN":["1558-8211","1558-822X"],"issn-type":[{"value":"1558-8211","type":"print"},{"value":"1558-822X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,3]]},"assertion":[{"value":"7 July 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"N\/A","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This article does not contain any studies with human or animal studies performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}]}}