Outcomes of chronic myeloid leukemia patients after therapeutic failure to conventional tyrosine kinase inhibitors and asciminib

Patients with chronic myeloid leukemia (CML) who have failed conventional tyrosine kinase inhibitors (cTKIs) and asciminib constitute a complex group of patients with few therapeutic options. A retrospective descriptive multicenter observational study was carried out including patients with CML who had presented a therapeutic failure to ≥ 2 cTKIs and asciminib, and had received or were not candidates to ponatinib. Of the 19 patients enrolled, 8 patients failed asciminib due to intolerance and 11 due to resistance. The most common strategy for intolerant patients was to initiate a previously administered cTKI (6/8) with dose adjustments or symptomatic management of adverse events (AEs). Of the patients who failed due to resistance, only patients who underwent progenitor transplantation achieved profound long-term responses. A frequent strategy was to use ponatinib (4/11) in patients previously considered non-candidates, with poor responses in patients in whom dose reductions were used, and severe AEs in patients at standard doses. In the remaining patients, cTKIs and other agents (interferon, hydroxyurea, citarabine, busulfan) were used with poor responses. Patients who progressed to advanced stages had a dismal prognosis. With a median follow-up of 11.2 months, overall survival of the global cohort was 73%; 100% for intolerant patients, 71% for resistant patients and 25% for those who discontinue asciminib in accelerated/blastic phase.

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Publication Details

Journal
Annals of Hematology
Published
2024-09-13
DOI
https://doi.org/10.1007/s00277-024-05906-6
Citations
3
Primary Topic
Chronic Myeloid Leukemia Treatments
Type
article
Field-Weighted Citation Impact
1.36
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article

Outcomes of chronic myeloid leukemia patients after therapeutic failure to conventional tyrosine kinase inhibitors and asciminib

Marta Hidalgo Soto, Magdalena Sierra Pacho, Adrián Segura Díaz, Patricia Vélez Tenza et al.
3 citations
Annals of Hematology
Chronic Myeloid Leukemia Treatments
1.36
article

Outcomes of chronic myeloid leukemia patients after therapeutic failure to conventional tyrosine kinase inhibitors and asciminib

Marta Hidalgo Soto, Magdalena Sierra Pacho, Adrián Segura Díaz, Patricia Vélez Tenza, Javier López Marín, Antonio Paz Coll, Luis Felipe Casado, Natalia de las Heras, Valentín García‐Gutiérrez, Anna Angona, Marta Santaliestra, Montse Cortés, Elvira Mora, Alicia Senín Magán, Araceli Salamanca Cuenca, Lucía Pérez‐Lamas, Carlos Cerveró, Raquel de Paz
article en
3 citations

Abstract

Patients with chronic myeloid leukemia (CML) who have failed conventional tyrosine kinase inhibitors (cTKIs) and asciminib constitute a complex group of patients with few therapeutic options. A retrospective descriptive multicenter observational study was carried out including patients with CML who had presented a therapeutic failure to ≥ 2 cTKIs and asciminib, and had received or were not candidates to ponatinib. Of the 19 patients enrolled, 8 patients failed asciminib due to intolerance and 11 due to resistance. The most common strategy for intolerant patients was to initiate a previously administered cTKI (6/8) with dose adjustments or symptomatic management of adverse events (AEs). Of the patients who failed due to resistance, only patients who underwent progenitor transplantation achieved profound long-term responses. A frequent strategy was to use ponatinib (4/11) in patients previously considered non-candidates, with poor responses in patients in whom dose reductions were used, and severe AEs in patients at standard doses. In the remaining patients, cTKIs and other agents (interferon, hydroxyurea, citarabine, busulfan) were used with poor responses. Patients who progressed to advanced stages had a dismal prognosis. With a median follow-up of 11.2 months, overall survival of the global cohort was 73%; 100% for intolerant patients, 71% for resistant patients and 25% for those who discontinue asciminib in accelerated/blastic phase.

Annals of HematologyVol. 103(11)
Hospital Universitario La Paz (ES), Hospital Universitari i Politècnic La Fe (ES), Hospital Virgen de la Luz (ES), Hospital Universitario de Gran Canaria Doctor Negrín (ES), Complejo Hospitalario de Salamanca (ES), Hospital Universitario Puerta de Hierro Majadahonda (ES), Hospital General de Granollers (ES), Hospital Virgen de la Salud (ES), Instituto Ramón y Cajal de Investigación Sanitaria (ES), Vall d'Hebron Hospital Universitari (ES), Mútua Terrassa (ES), Hospital Del Mar (ES), Hospital General Universitario de Alicante Doctor Balmis (ES), Hospital Universitario Puerto Real (ES), Duran i Reynals Hospital (ES), Hospital Jerez Puerta del Sur (ES), Hospital Universitari de Girona Doctor Josep Trueta (ES), Hospital Universitario de León (ES)
Good health and well-being
Openalex Percentile: Top 17%
Chronic Myeloid Leukemia Treatments
1.36
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