Table 1.

Recommendations for allogeneic stem cell transplantation in CML according to the ELN and the NCCN

Chronic phase (chP)	Accelerated phase (AP)	Blast phase (BC)
ELN 202025 - Disease resistant or intolerant (suboptimal response to 2 or more TKIs) - For the very rare patient with inadequate recovery of normal hematopoiesis - Resistance to 2G-TKIs (first or second line) ponatinib or experimental agent - Failure to respond to ponatinib after 3 months' treatment - Emergence of high-risk cytogenetics: observe closely, consider intensification of treatment (ponatinib, early allo-SCT)	ELN 202025 - A patient presenting in AP should be treated as a high-risk patient, becoming eligible for HSCT if the response is not optimal - A patient progressing to AP during treatment should immediately be considered for HSCT	ELN 202025 - Attempt at return to chP2 - Addition of chemotherapy based on AML regimens for myeloid BP (such as dasatinib or ponatinib + FLAG-IDA) or ALL regimens for lymphoid BP (such as imatinib or dasatinib + hyperfractionated CVAD) recommended - After CP2 is achieved proceed to allo-SCT without delay - Transplantation in active BP is not recommended
NCCN guidelines26 - If TKI-resistant disease BCR-ABL1 (IS) >10% at >3 months, switch to alternate TKI and evaluate for HSCT	NCCN guidelines26 - Disease progression to AP while on TKI therapy should be considered for HSCT - Patients who present with AP at diagnosis should be treated with a TKI, followed by evaluation for allogeneic HSCT based on response to therapy after 3, 6, or 12 months	NCCN guidelines26 - Recommendation does not depend on response - After therapy with morphology-based induction chemotherapy + TKI in lymphoid and myeloid blast crisis or TKI plus steroids in lymphoid blast crisis and sole TKI in myeloid blast crisis

CVAD, chemotherapy combination used to treat some types of acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL). Hyper-CVAD includes the drugs cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride (Adriamycin), and dexamethasone; FLAG-IDA, fludarabine, high-dose cytosine arabinoside (AraC), idarubicin, and granulocyte colony-stimulating factor (G-CSF); IS, international scale.