Hi.
I want to have your thoughts on the same case we discussed a while ago. The patient is now 20 yo. He has failed with three TKIs, started asciminib in Apr 2022, and maintained the PCR in 0.1-0.2%IS range but attained MMR only a few times. I previously said he was on 40 mg BID, but actually, he was on 80 mg QD.
He came back for follow up recently and PCR went up to 2%. I asked our BMT team to do donor search again and now, they have an unrelated donor with 9/10 match. (Previously, there was only haplo.) I have thought about switching asciminib to ponatinib, but I think the same thing will likely happen; he will respond, but will lose molecular remission after a while.
With a better donor option, I am thinking about taking him to HSCT now.
I would appreciate your suggestions
Nobuko Hijiya
Columbia University, NYC