Case Discussion: Complex CML Management - Dr. Cardemil’s Case

Context

During the recent iCMLf Key Discussions on CML - Latin America, Dr. Cardemil from Chile shared a particularly challenging case of CML for discussion. Unfortunately, due to time constraints, we couldn’t address the case during the live session. However, our expert panel, including Dr. David Yeung and Dr. Jeff Lipton, reviewed the case post-event and provided their expert insights.

Expert Recommendations

Dr. David Yeung and Dr. Jeff Lipton analyzed the case and offered the following advice:

• Dasatinib and Bosutinib were ruled out due to associated risks of pulmonary hypertension and effusion.
• Imatinib was also excluded due to the presence of the M244V mutation.
• The remaining treatment options include Nilotinib, Ponatinib, and Asciminib.
• Ponatinib at 45mg QD was suggested for its efficacy, although a careful assessment of side effects is essential.
• Asciminib was recommended as an alternative, particularly at 200mg BID if it can be obtained, considering the potential decreased sensitivity due to the M244V mutation.
  
  

Next Steps

We invite all members of the CML community to review this case and share any further insights or questions. Your contributions help us collectively advance our understanding and treatment of CML.

Related Resources:

• Watch the Full Session Recordings - English, Spanish and Portuguese

For any questions or further discussion, please feel free to reach out to us.