How do you approach a patient with CP-CML who has a history of inadequate response and severe myelotoxicity to multiple TKIs such as imatinib, nilotinib and dasatinib?

Topics: Hematologic Malignancies • Medical Oncology • Leukemia • CML • Hematology

The patient has also acquired mutations in BCR-ABL, namely p.Met244Val, (c.730A>G); 3.7%, which may confer resistance, and p.Phe359Cys, (c.1076T>G); 4.2%.

Answer from: Medical Oncologist at Community Practice

This depends in part, on the status of the disease (transcript levels), the doses of TKIs that have been used, the nadir blood counts, what lineages are involved in myelosuppression, and the comorbidities of the patient. In principle, ponatinib or asciminib could be used. If ponatinib, I would start...

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Medical Oncologist at Oncology Consultants
Thank you so much Dr. @Jorge E. Cortes. Imatinib 3...

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