Translate page

× To share and enhance best practice management of CML, experts and interested clinicians can discuss difficult or interesting CML cases here. Physicians submit a brief history of the patient and the case for discussion (no more than 200 words) by posting it in this forum ("New Discussion" button below). Please include the country of origin.

Each clinical case will be forwarded to the expert clinical panel for a brief independent response. Consideration should be given to patient confidentiality. Details that are not critical to the case can be changed to preserve anonymity. Please consider including your email with the case. This will not be posted on the website, but is useful should further details be requested by the moderator.

As a full clinical history is necessary for accurate comment, cases and comments on the Forum are ONLY ACCEPTED FROM PHYSICIANS. If individual patients have a specific question we encourage them to contact their healthcare provider. General questions can be emailed to info@cml-foundation.org.

DISCLAIMER: The iCMLf does not recommend or endorse any specific tests, physicians, products, procedures, or opinions, and disclaims any representation, warranty, or guaranty as to the same. Reliance on any information provided in this Forum is solely at your own risk.

24 Y Female | CML-AP - 11 Yr | 3 TKI+ (T315I Mut.) | Treatment after Ponatinib

  • Michael Deininger
  • Michael Deininger's Avatar
2 years 2 months ago - 2 years 2 months ago #1884 by Michael Deininger
NEW RESPONSE – Mike Deininger

Here is my recommendation:

First of all bmbx to assess disease phase.

 If blasts <=15% proceed to haplo from mother asap. Fifty-seven years of age should be fine. Continue ponatinib up to 5 days prior to bmt and resume at 15mg post bmt upon count recovery
 If blasts >15% consider giving 1 cycle of FLAG-Ida and stand by to proceed with bmt from mother in case of prolonged myelosuppression. I don’t think there is clear-cut data to support this, so needs to be discussed with patient in this way.

I am not aware of any therapy that would address the ASXL1 mutant clone. One could consider adding 5-aza, but I would worry this may delay BMT without gaining much.
Last edit: 2 years 2 months ago by arlene.
Moderators: Nicolaarlene