Clinical Case Discussion Forum

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 using this forum.

Three-way Philadelphia chromosome

Topic Three-way Philadelphia chromosome was created by Dr Nasir Ahmad
Dr Nasir Ahmad Pakistan 04:02 21 February 2019

Respected all! I am relatively new and has worked in lab mostly. I found a case three-way Philadelphia translocation 46,xy, t (3;9;22) (p21;q34;q11.2). He has been prescribed imatinib 400 mg OD and is doing well apparently.

I want to know if he needs to switch to nilotinib, is there any guidelines showing which drug should the patient use?

Nasir
PhD research student

Reply by Professor Susan Branford on topic Three-way Philadelphia chromosome
Professor Susan Branford Australia 04:57 21 February 2019

The MD Anderson published their data in 2004 that assessed the results of imatinib for patients with variant Philadelphia chromosome (El-Zimaity et al, Br J Haematol, 2004:125;187-95). In a multivariate analysis, the variant Ph had no impact in response rate, overall survival or duration of response.

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