尽管大多数慢性髓性白血病（CML）患者表现为慢性期，并预期有正常的预期寿命，但一些患者表现为或进展到更具侵袭性的加速期（AP）或爆发期（BP）的CML。在此，我们讨论了CML进展期的诊断考虑，并回顾了其当代管理。更先进、更有效的BCR-ABL1酪氨酸激酶抑制剂（TKIs）如泊那替尼可能在CML进展期患者中导致更好的结果。对于CML-BP，针对爆发免疫表型的联合策略似乎优于TKI单药治疗。异基因干细胞移植在CML-AP中的作用存在争议，但已经一致表明对CML-BP患者的预后有所改善。进展期CML，尤其是CML-BP，仍然是CML的不良风险亚型。然而，针对后续世代的TKIs的新型联合策略正在临床试验中研究，并可能带来改善的预后。©2023. 作者独家授权给斯普林格科学+商业传媒有限公司，属于斯普林格自然出版集团的一部分。

While most patients with chronic myeloid leukemia (CML) present in a chronic phase and are expected to have a normal life expectancy, some patients present with or progress to a more aggressive accelerated phase (AP) or blast phase (BP) of CML. Herein, we discuss the diagnostic considerations of advanced phase CML and review its contemporary management.Later-generation, more potent BCR::ABL1 tyrosine kinase inhibitors (TKIs) such as ponatinib may result in superior outcomes in patients with advanced phase CML. For CML-BP, combination approaches directed against the blast immunophenotype appear superior to TKI monotherapy. The role of allogeneic stem cell transplantation is controversial in CML-AP but has consistently been shown to improve outcomes for patients with CML-BP. Advanced phase CML, particularly CML-BP, remains a poor risk subtype of CML. However, novel combination approaches using later-generation TKIs are being explored in clinical trials and may lead to improved outcomes.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.