ابيضاض الدم النقوي المزمن بعد فشل مثبطات كيناز التيروزين من الجيل الثاني: ما هي الخطوة التالية؟

References

DOI: 10.1002/ajh.27443

• In such patients, changing to a third-generation TKI is better.
• We recommend using ponatinib 45 mg daily in T315I-mutated CML and 30 mg in non-T315I-mutated CML, with dose reductions to 15 mg daily once the BCR:ABL1 transcripts (IS) are ≤1%.
• Based on these results, the FDA approved asciminib 40 mg BID for the treatment of CML-CP post-failure of 2+ TKIs without T315I or V299L mutations.
• The recommended phase III dose of olverembatinib was 30 or 40 mg every other day in patients with CML-CP without or with the T315I mutation, respectively.
• In patients with resistance to a second-generation TKI without guiding mutations or with T315I mutation, a third generation TKI and consideration of allo-HSCT are indicated.
• After a median follow-up of 5 years, 60% of patients achieved MCyR (primary endpoint) at any time; 82% of those remained in MCyR at 5 years.