Table 2.

Indications of HSCT for CML in the Current Era.

Indication	Summary
Cost-effectiveness in low-income countries	Financial barriers hinder access to TKIs in developing countries, making HSCT a more feasible and cost-effective option.
Children and young adults	HSCT demonstrates favorable outcomes and may be preferred over lifelong TKI therapy for pediatric and young adult patients.
Aiming for TFR in CML	Achieving treatment-free remission is a goal; however, HSCT remains the only curative therapy for long-term remission.
Intolerance and resistance of TKIs	HSCT is recommended for patients resistant or intolerant to TKIs, providing better long-term survival opportunities.
Blast crisis	HSCT is vital for patients in blast crisis, achieving long-term remission and improved survival rates.
Advanced accelerated-phase CML	HSCT offers better outcomes than TKIs, particularly in late accelerated-phase cases.
T315I mutation in CML	Ponatinib is effective for T315I-positive chronic-phase CML, but HSCT should be considered for Ponatinib resistance and advanced stages of CML.
Concurrent myelodysplastic syndromes	HSCT can lead to complete remission of both myeloid and lymphoid malignancies, providing a potential, curative option.

Caption: Summary of indications for HSCT in CML based on different clinical scenarios and disease stages. HSCT offers curative potential, better outcomes, and cost-effectiveness in specific patient populations. Abbreviations: TKIs, tyrosine kinase inhibitors; HSCT, hematopoietic stem cell transplantation; TFR, treatment-free remission; CCyR, complete cytogenetic response; OS, overall survival; LFS, leukemia-free survival; EFS, event-free survival; CMR, complete molecular remission; MDS, myelodysplastic syndrome.