Abstract
The guideline for the diagnosis and treatment of chronic myeloid leukemia (CML) in China (2025 edition) has been revised based on its 2020 version, incorporating advances in the field of CML diagnosis and treatment over the past 5 years. With reference to the revised 2022 International Consensus Criteria, the threshold for lymphoblasts in lymphoid blast transformation is clearly defined. The EUTOS Long-Term Survival score is recommended to evaluate the patient's risk status at diagnosis. Meanwhile, a prediction model for tyrosine kinase inhibitor (TKI) treatment failure derived from Chinese multicenter data is also recommended. The prognostic significance of cytogenetic and molecular abnormalities should be considered. Newly therapeutic drugs include asciminib, olverembatinib, and ponatinib. This version of the guideline systematically elaborates on the decision-making principles for first-line and later-line medications. Milestone responses are of guiding significance for treatment strategy adjustments; however, we emphasize that molecular milestone responses should be interpreted individually. Concurrently, it proposes TKI dose optimization based on efficacy and safety. The implementation criteria for treatment-free remission, postdiscontinuation monitoring, and fertility-related issues have been adjusted to minimize toxicities and improve quality of life while ensuring efficacy. Allogeneic hematopoietic stem cell transplantation remains valuable for patients with multidrug TKI resistance or intolerance and those in advanced phases.