The recently published “Management of children and adolescents with chronic myeloid leukemia in chronic phase: International pediatric chronic myeloid leukemia expert panel recommendations” in the prestigious journal Leukemia marks a historic milestone as the first international expert consensus focused on chronic-phase chronic myeloid leukemia (CML) in children and adolescents.

This consensus consolidates the insights and clinical experience of leading pediatric hematology experts from around the world and offers systematic guidance on the diagnosis, treatment, and long-term management of this rare disease in the pediatric population.

Notably, two Chinese experts—Dr. Wenyu Yang and Dr. Wenbin An from the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences—played key roles in drafting this landmark document. This marks the first time that Chinese scholars have participated in the development of international guidelines for pediatric CML, representing a significant advancement for China in this specialized field.

In this exclusive interview, Hematology Frontier invites Dr. Yang and Dr. An to share their reflections on the consensus development process, its key highlights, and its implications for improving clinical practice in China. Through their insights, we hope to inspire and inform hematology professionals across the country, further advancing the care of children with CML.

Hematology Frontier：Recently, the world’s first international expert consensus on pediatric chronic myeloid leukemia (CML) was published in Leukemia. As two of the Chinese experts who participated in drafting this groundbreaking consensus, could you each share your overall impressions of being involved in the process?

Dr. Wenyu Yang: The international expert consensus on the management of chronic-phase pediatric chronic myeloid leukemia (CML) was officially published in early March this year. We were honored to be involved in the drafting and development of this important document. Throughout the process, we had the opportunity to engage in deep exchanges with leading global experts in the CML field, which was both enriching and inspiring.

Although pediatric CML is a rare hematologic disease with a relatively small patient population, the need for standardized and evidence-based treatment is no less critical. While some national guidelines exist in China, there had previously been no authoritative international consensus or guideline focused specifically on the chronic phase of pediatric CML. The release of this document provides much-needed clarity and direction for hematology experts in China and will help improve overall treatment outcomes and long-term prognosis for children living with CML.

Dr. Wenbin An: I would summarize my experience with three key words: honor, responsibility, and confidence. This consensus represents the first comprehensive, evidence-based clinical guideline issued by the International Pediatric CML Working Group specifically for chronic-phase pediatric CML. Drawing from our team’s long-term follow-up data and extensive clinical experience with one of China’s largest pediatric CML cohorts, we contributed valuable perspectives—particularly on the selection of tyrosine kinase inhibitors (TKIs), evaluation of treatment response, and monitoring of adverse effects.

This is also the first time Chinese scholars have participated in writing an international guideline on pediatric CML.

Throughout the drafting process, we were deeply impressed by the recognition the international academic community has shown toward China’s clinical and research contributions in pediatric CML. After several rounds of discussion and revision, the final version was reached. The section on acute adverse reactions and management, which was led by our team, received strong endorsement from experts in Europe and the U.S. The seriousness, mutual respect, and open academic dialogue that defined this collaboration were truly inspiring—and they gave us greater confidence in contributing Chinese expertise to global pediatric hematology in the future.

Hematology Frontier: Dr. Yang, with your extensive research and clinical experience in pediatric CML, what do you consider the key highlights of this international consensus? How do you think its publication will influence pediatric CML care globally?

Dr. Wenyu Yang: The publication of this international consensus provides a comprehensive and systematic framework for the diagnosis and treatment of chronic-phase pediatric CML. As a rare disease, pediatric CML presents unique clinical challenges, and the chronic phase represents the majority of patient cases.

This consensus document thoroughly outlines the treatment principles for first-, second-, and third-generation tyrosine kinase inhibitors (TKIs), and provides clear, actionable recommendations for risk stratification and treatment adjustment in cases of chemotherapy intolerance or resistance. These recommendations are grounded in robust data from both international and domestic large-scale studies, making them both evidence-based and highly practical.

In short, the consensus offers a full-spectrum guide—from precision diagnosis to individualized therapy, and even forward-looking insights into treatment discontinuation strategies. It is expected to significantly enhance the global standard of care for children with chronic-phase CML and will serve as an essential reference for pediatric hematology-oncology professionals worldwide.

Hematology Frontier: Dr. An, as a key contributor to the consensus, what aspects of Chinese research or clinical experience do you think provided critical input into the development of the guidelines?

Dr. Wenbin An: Chinese experts have made substantial contributions to the field of pediatric CML, and these were directly reflected in the formulation of the international consensus. This includes not only the work done at our center but also the achievements of other centers across the country.

Under the leadership of Dr. Yang, our team established a dedicated pediatric CML database years ago. To date, it includes several hundred pediatric cases, with long-term follow-up data exceeding five years for some patients. For a rare disease like CML, this represents a relatively large and well-documented cohort, offering invaluable insights into treatment selection and adverse event management.

Additionally, given that our center also treats a large number of children with acute lymphoblastic leukemia (ALL), we have developed deep expertise in managing pediatric Philadelphia chromosome-positive (Ph+) ALL. This allowed us to contribute crucial guidance on how to accurately differentiate between lymphoid blast crisis of CML and de novo Ph+ ALL in children—an important distinction that informed the consensus. These research findings, which have already been published, not only highlight China’s scientific capabilities in pediatric CML but also provide key support for refining global standards of care.

Hematology Frontier: Dr. Yang, how do you think this international consensus will help advance the standard of care for pediatric CML in China? In what specific ways could it positively influence current clinical practices?

Dr. Wenyu Yang: The release of this international consensus on the diagnosis and treatment of chronic-phase pediatric CML provides clear and systematic guidance for domestic experts in areas such as diagnostic criteria, initial treatment decisions, and response evaluation throughout the treatment process.

Although pediatric CML is classified as a rare disease, given China’s large population, it is not uncommon in clinical settings. That said, there are still inconsistencies in treatment approaches across the country, particularly regarding the choice of initial medication, timing of treatment monitoring, and the frequency and indications for bone marrow aspiration. This consensus offers a structured framework that defines specific time points and methods for monitoring, which can greatly support the standardization of clinical practice for chronic-phase pediatric CML in China.

By aligning practice with evidence-based recommendations, this consensus is expected to improve therapeutic outcomes while also helping to reduce unnecessary bone marrow procedures—thereby easing the physical burden on young patients. I believe it will play a vital role in guiding domestic clinicians on both treatment selection and monitoring strategy.

Hematology Frontier: Dr. An, following the release of the international consensus, what challenges do you foresee in implementing it in China? How can we overcome these barriers to ensure more pediatric CML patients benefit from its guidance?

Dr. Wenbin An: Implementing the international consensus in China may face several challenges due to differences between China’s healthcare environment and that of other countries. In my view, the three most pressing issues are:

1. Limited long-term adverse event management – While our diagnostic capabilities and early adverse reaction management are aligned with international standards, we still lack comprehensive systems for managing long-term side effects. Pediatric CML patients often require long-term medication, which calls for continuous, multidisciplinary monitoring. Yet, multidisciplinary team (MDT) clinics specifically for pediatric CML are still lacking in China.
2. Access to medication – The consensus recommends second-generation TKIs, such as dasatinib, for high-risk patients identified by ELTS scoring. However, dasatinib is not yet covered by China’s medical insurance for pediatric CML, and bosutinib has not been approved for use in China at all.
3. Limited molecular monitoring for treatment discontinuation – One of the key goals proposed in the consensus is treatment discontinuation, but this requires frequent and sensitive molecular monitoring. Unfortunately, diagnostic capabilities vary widely across hospitals in China, and many patients must travel to major centers for testing. This reduces adherence and complicates implementation.

To address these issues, we are in the process of establishing a multicenter pediatric CML collaboration group. This initiative aims to promote standardized diagnosis and treatment practices nationwide, while also creating regional quality control hubs.

We are also planning to launch MDT clinics in collaboration with specialists in pediatric endocrinology, cardiology, and other relevant fields, to build a long-term adverse event monitoring system tailored to Chinese patients. This would not only improve quality of life but also reduce unnecessary testing and travel—providing dual benefits for families and the healthcare system.

Hematology Frontier: As a global guideline, the international consensus holds significant value. Dr. Yang, from your perspective, what does its publication mean for enhancing the international influence of Chinese experts in the field of hematology?

Dr. Wenyu Yang: Over the past five to ten years, driven by scientific and technological advancements, China’s medical capabilities—particularly in pediatric hematology—have made tremendous progress and are approaching international leadership in many areas.

The release of this international consensus on chronic-phase pediatric CML presents an important opportunity for Chinese hematology experts to step more confidently onto the global academic stage. We hope this consensus will not only serve as a valuable reference for domestic hematology-oncology specialists in standardizing the diagnosis and treatment of pediatric CML, but also act as a platform to foster deeper collaboration between Chinese and international experts further enhancing the global visibility of China’s contributions in this field.

Historically, much of our research has been based on single-center experiences and retrospective summaries. Moving forward, we aim to use this consensus as a foundation for launching national multicenter retrospective and prospective studies in pediatric CML. By sharing China’s research achievements with the global community, we can highlight the contributions of Chinese scholars and strengthen our connections with international peers.

Ultimately, all these efforts aim to ensure that children in China living with CML receive more effective, standardized, and compassionate care—improving both their clinical outcomes and overall quality of life.

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Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences

• MD, Chief Physician, Head of the Pediatric Hematology Center and Pediatric Day Ward
• Master’s Supervisor
• Member, Pediatric Hematology Group, Chinese Society of Hematology
• Member, CML Expert Committee, China Anti-Cancer Association
• Member, National Health Commission Expert Group on Pediatric Blood Disorders
• Member, Tianjin Medical Association Pediatric Hematology Group
• Member, Tianjin Anti-Cancer Association
• Editorial Board Member, Chinese Journal of Pediatric Hematology Oncology
• Principal Investigator for projects under the National Natural Science Foundation of China and Ministry of Education clinical translation programs
• First author or corresponding author of multiple papers published in Lancet Oncology, Annals of Hematology, International Journal of Hematology, Chinese Medical Journal, Chinese Journal of Pediatrics, and others

Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences

• Attending Physician, Peking Union Medical College
• Visiting Scholar, Stanford University School of Medicine
• Visiting Scholar, Cincinnati Children’s Hospital Medical Center
• Specializes in the diagnosis and treatment of pediatric myeloproliferative neoplasms
• Principal Investigator for one project funded by the National Natural Science Foundation of China and one Tianjin Municipal Science Foundation project; also involved in multiple national and ministerial-level research projects
• First author or co-author of papers published in Blood, Journal of Hematology & Oncology, Journal of Nucleic Acids Research, Pediatric Blood Cancer, eLife, and other SCI-indexed and core international journals