Allogeneic transplant remains the only proven cure for CML and should be strongly considered in young, highly motivated patients with HLA-identical siblings. Current disease models also suggest that survival is extended by imatinib, and therefore an initial therapeutic trial of the agent is also reasonable. Autologous BMT is rarely performed for CML due to the predictability of response to imatinib and the low level of toxicity. As data regarding imatinib resistance have come to prominence, novel approaches to treat resistant disease are sought. Here it is possible that autologous transplant may return to prominence as the cohort currently being treated with imatinib ages and resistance becomes more common over time. A growing number of second-generation abl kinase inhibitors have been developed to treat this looming threat.
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