Translate page

× To share and enhance best practice management of CML, experts and interested clinicians can discuss difficult or interesting CML cases here. Clinicians submit a brief history of the patient and the case for discussion (no more than 200 words) by posting it in this forum ("+ NEW TOPIC" 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 CLINICIANS. 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.

CML intolerant/resistant to all TKIs

More
9 years 3 months ago #250 by dsnyder@coh.org
Some additional information: He has no detectable BCR-ABL mutation. He has been on TKI therapy without interruptions, at reduced doses of the TKIs because of the cytopenias (dasatinib 100mg then 70mg a day; nilotinib 300mg BID then 150 mg BID; bosutinib 300mg a day; ponatinib 15 mg a day.)
David Snyder
  • Pankaj Malhotra
  • Pankaj Malhotra's Avatar
9 years 3 months ago #251 by Pankaj Malhotra
Replied by Pankaj Malhotra on topic Re: CML intolerant/resistant to all TKIs
This additional information is very useful. Information on bone marrow cellularity, number of blasts, presence of myelofibrosis and type of BCR ABL transcripts and presence of any co-morbidities in the patient would be highly appreciated.
More
9 years 3 months ago - 9 years 3 months ago #253 by Trey
Some patients require significant dose reduction for pancytopenia when the issue is multi-drug intolerance. For instance, some patients have responded to dosage as low as 20mg dasatinib, which has allowed continuous drug therapy and also marrow recovery. Dr Cortes at MDA can consult on this.

Trey
CML Patient Advocate
USA
Last edit: 9 years 3 months ago by Nicola. Reason: Qualification
Moderators: Melissa Davis-Bishop