Anticipate Your Next Move in Chronic Myeloid Leukaemia Patient Management

Abstract

Treatment decisions in chronic myeloid leukaemia (CML) are complex and require the evaluation of many factors at each stage of therapy. Many patients will become resistant or intolerant to the first and subsequent lines of tyrosine kinase inhibitors (TKI) they receive, requiring them to switch to a different TKI. Clinicians are faced with many considerations when choosing subsequent treatments and an important issue is how best to manage failure on a second-generation TKI. During an interactive and case-based, Incyte-sponsored, satellite symposium at the 2019 European Hematology Association (EHA) congress, Dr Janssen and Prof Apperley discussed the current best practices for managing patients failing imatinib or second-generation TKI, considering whether second-generation TKI should be used sequentially and the timing of the introduction of a third-generation TKI (ponatinib). Dr Soverini and Dr de Lavallade discussed how regular BCR-ABL response monitoring and mutational analysis are integral to CML patient management. They highlighted the clinical relevance of low-level mutations and the necessity to prevent clonal expansion of these TKI-resistant mutants, and the accumulation of additional mutations, by switching to an effective TKI in a timely manner.