Internal Medicine

CML

Questions discussed in this category

Would you change therapy for a CML patient in hematologic remission on imatinib found with positive qualitative BCR-ABL1 for the p230 protein?

qPCR for BCR/ABL was negative. FISH remained positive.

1 Answer available

How would you manage a patient with CML in chronic phase with a significant cardiac history, such as heart failure with reduced ejection fraction or arrhythmia?

Is there a specific tyrosine kinase inhibitor that you would prefer to use?

1 Answer available

Do you recommend continued PCR testing in a CML patient who underwent allogeneic stem cell transplantation with an identical match about 20 years ago?

1 Answer available

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?

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>...

1 Answer available

Do you switch from imatinib to another TKI in patients with chronic phase CML who develop renal insufficiency?

There are conflicting reports whether it contributes to renal insufficiency. If you do switch, what is your preferred TKI in this scenario?

2 Answers available

Based on the ASC4MORE trial, would you add asciminib to imatinib if patients don’t achieve deep molecular remission at 1 year?

2 Answers available

How would you treat a patient with chronic phase CML who could not tolerate nilotinib due to G4 thrombocytopenia despite sequential dose reductions?

1 Answer available

What is the appropriate management of arthralgias associated with bosutinib?

1 Answer available

In patients with CML on imatinib and newly diagnosed breast cancer now requiring radiation therapy, should we hold imatinib?

The said patient has been on Imatinib for 2.5 years and is In MMR. Last rt-PCR was 0.04.

3 Answers available

How should one manage a patient with leukocytosis and borderline detectable BCR-ABL without other clinical features of CML such as basophilia or splenomegaly?

e.g. IS < 0.002% by qPCR

1 Answer available

Would you routinely use G-CSF prophylaxis in a CMML patient for decitabine-related neutropenia?

1 Answer available

Would you add chemotherapy to a TKI in treating an elderly patient with de novo CML blast crisis?

1 Answer available

How would you manage CML first-line second generation TKI with a best response of MMR 4, but now with a loss of MMR with more than one log response loss but still in complete cytogenetic remission and mutation panel negative?

1 Answer available

Are there any special considerations for treating CML in the very elderly, greater than 85 years old?

1 Answer available

How do you approach the treatment of patients with an e14a3 (b3a3) BCR-ABL fusion in chronic phase CML?

1 Answer available

What's your preferred management for a newly diagnosed chronic phase CML with concurrent thrombocytopenia?

1 Answer available

How long after discontinuation of TKI (for complete remission) would you feel it is safe for a patient with CML to consider pregnancy?

1 Answer available

What factors do you consider when choosing between a 1st and 2nd generation TKI in a newly diagnosed CML patient?

1 Answer available

Do you ever start with lower than standard doses of TKIs when initiating treatment for chronic phase CML?

For instance, do you ever start with dasatinib 50 mg daily? Are there any titration schedules that you follow?

1 Answer available

Can we ever observe newly diagnosed chronic phase CML patients and not immediately start them on therapy?

if so, are there specific cytogenetic, molecular, clinical, or hematologic factors that you take into consideration?

2 Answers available

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

Thrombosis was ruled out and no etiology was found. Would you start ponatinib back at a lower dose, transition to omacetaxine or begin transplan...

1 Answer available

Would you use alternative management in a chronic phase CML with a 3 way translocation between chromosome 9, 22 and 7?

1 Answer available

What is your preferred dosing and schedule for interferon in pregnant CML patients?

1 Answer available

For male patients in chronic phase CML on a TKI and not yet in a MMR, is there a preferred amount of time spent in a MMR before discontinuing TKI therapy to conceive or bank sperm ?

Drug information indicates a patient may need 3-4 months off TKI. This seems like a long time off drug. Would a MMR of a certain duration make it less...

1 Answer available

How would you approach a chronic phase CML patient who is responding to second generation TKI but not yet in molecular remission and is now pregnant?

2 Answers available

Papers discussed in this category

British journal of haematology, 2004-04

Results of imatinib mesylate therapy in chronic myelogenous leukaemia with variant Philadelphia chromosome.

Blood,

Impact of additional cytogenetic aberrations at diagnosis on prognosis of CML: long-term observation of 1151 patients from the randomized CML Study IV.

Blood,

Variant Philadelphia translocations: molecular-cytogenetic characterization and prognostic influence on frontline imatinib therapy, a GIMEMA Working Party on CML analysis.

Clin Lymphoma Myeloma Leuk, 2017 Jun 21

Influence of BCR-ABL Transcript Type on Outcome in Patients With Chronic-Phase Chronic Myeloid Leukemia Treated With Imatinib.

BMC Cancer, 2010 Aug 09

In vitro effects of imatinib mesylate on radiosensitivity and chemosensitivity of breast cancer cells.

J Clin Pharmacol, 2021 Jul 16

Pharmacokinetics of Asciminib in Individuals With Hepatic or Renal Impairment.

Leukemia, 2023 Sep 19

Survival with chronic myeloid leukaemia after failing milestones.

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