We have a patient of 43 years old, diagnosed of accelerated phase cml in november 2021. Constitutional symptoms and GIV splenomegaly were the main symptoms. BM Immunophenotype: 16% myeloid blasts. BM CG: 100% Ph+. BCR-ABL + p210. He started treatment in another center outside Montevideo, with Imatinib 400mg day (most easily accessible in Uruguay). He had complete hematologic response. In April 2022 he discontinued tratment, evolving to a blastic phase in May.
BM Immunophenotype: 48% myelod blasts. CG/FISH: complex karyotype, t(9:22) in 67%. T315I negative. HLA study was perfomed. We started FLAG IDA protocol associated with Imatinib 800mg day. Nowadays he is at D17 postchemo. BM Immunophenotype: 60% myeloid blasts. We´re waiting for the authorization of Dasatinb by our government comitee.
We would appreciate your opinion about how to continue the treatment in this case, wich is the best chimio option.
Best regards, Camila Guidali MD, from Montevideo Uruguay