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

  • Michael Deininger
  • Michael Deininger's Avatar
1 year 7 months ago - 1 year 7 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: 1 year 7 months ago by arlene.
Moderators: Nicolaarlene