Single-cell sequencing in precision management of chronic myeloid leukemia

Abstract

Single-cell sequencing technology provides a high-resolution perspective for the precision diagnosis and treatment of chronic myeloid leukemia (CML). Cellular and molecular heterogeneity in CML is closely associated with tyrosine kinase inhibitor resistance, residual disease, and disease progression. However, the averaged signals generated by conventional bulk sequencing limit the identification of minor resistant clones, state-dependent leukemia stem cell (LSC) programs, and complex microenvironmental interactions. This review summarizes frontier applications of single-cell RNA sequencing and related single-cell omics technologies in CML, including molecular mechanism analysis, tumor microenvironment profiling, resistance mechanism exploration, biomarker discovery, and the translation of these findings into risk stratification, treatment monitoring, and individualized therapeutic strategies. By integrating recent global research findings, this review discusses the value of single-cell technology in revealing the functional heterogeneity of LSCs and provides a balanced perspective on the future integration of spatial multi-omics, artificial intelligence-assisted analysis, and clinical decision systems. The aim is to clarify how CML diagnosis and treatment may move from empiric disease monitoring toward a more precise, single-cell-informed model while acknowledging current technical, economic, regulatory, and validation barriers.