632. Chronic Myeloid Leukemia: Therapy— Building The Future CML

Itaru Matsumura, Shigeki Ohtake, Yoshiko Atsuta, et al.

Authors Conclusion from the Abstract: Based on these results, we consider that nilotinib and dasatinib are equally effective for de novoCML-CP patients in achieving MR4.5 as well as in achieving CCyR and MMR in terms of both frequencies and times to achievement with similar continuity.

Tim H Brümmendorf, Jorge E. Cortes, Dragana Milojkovic, et al.

Authors Conclusion from the Abstract: At 5 y, first-line BOS continued to show superior efficacy vs IMA; BOS-treated pts achieved earlier and deeper molecular response. An improvement in MR with BOS was demonstrated across Sokal risk groups, with the greatest benefit vs IMA observed in Sokal high-risk pts. Long-term AEs were generally manageable, and consistent with previous reports and the known safety profiles of both drugs. These results confirm the use of BOS as a standard of care in pts with newly diagnosed CP CML.

 
Massimiliano Bonifacio, Chiara Elena, Mariella D'Adda, et al.
 
Authors Conclusion from the Abstract: Due to its retrospective nature, this study does not allow to define which is the optimal therapy for CML harboring CVT at diagnosis. However, our data reinforce the usefulness of bone marrow karyotyping in CML. The observed differences between partner chr. may also depend on the breaking points, which are variable. Further dissection of CVT will help to identify which are associated to a poor response to TKIs.
 

Jorge E. Cortes, Jane Apperley, FRCP, FRCPath, Andreas Hochhaus, et al.

Authors Conclusion from the Abstract: At this interim analysis with a median follow-up of ~21 months, the maximum benefit:risk, regardless of mutation status or number of prior TKIs, was observed in patients treated with a 45-mg starting dose, with a reduction to 15 mg upon achievement of response. Patients with the T315I mutation who initiated ponatinib at 45 mg experienced better response rates than those who initiated ponatinib at 30-mg or 15-mg starting doses. Primary analysis will provide a refined understanding of the benefit:risk profile of 3 different starting doses of ponatinib.

Naranie Shanmuganathan, Carol Wadham, Nur Hezrin Shahrin, et al.

Authors Conclusion from the Abstract: Despite a proactive strategy for TKI switch and a higher imatinib starting dose, the presence of cancer-related gene mutations or Ph-associated events conferred inferior outcomes. Combining the ELTS score with any mutational event further differentiated patient outcomes, demonstrating the power of integrating genomic data with current risk stratification.

Giorgina Specchia, MD1, Patrizia Pregno2*, Massimo Breccia, et al.

Authors Conclusion from the Abstract: In this first analysis of our study different clinical behaviors were observed among Italian hematologists, who prevalently prescribed IMA to older patients,with more comorbidities, as compared to 2genTKIs.These differences explain a better OS for patients treated with 2genTKIs vs IMA, however, the risk of death for CML related causes is quite similar between the two groups, all the differences being attributable to other causes of death.Prognostic baseline features associated to an increased OS confirmed that, in addition to age, the ELTS score and the comorbidities are the main clinical factors that independently influence the long-term OS.