How would you manage a CML patient with a T315I mutation that developed severe abdominal pain requiring hospitalization after starting ponatinib 45 mg?

If abdominal pain started after ponatinib was started it is important to rule out complications related to the drug. Thrombosis was ruled out, which is important as ponatinib can cause venous and arterial thrombosis. It is also important to rule out pancreatitis. If no other etiology is found and the pain resolves, I would restart ponatinib at a lower dose to see if this isn’t better tolerated and consider increasing in the future depending on how the patient is responding. With regards to additional therapy, regardless of this potential complication, a transplant evaluation should be considered now simply because of the T315I mutation. This is because there aren’t other effective therapies that are available outside of a risk that would be...