Part 1: Current Approach to Treating Chronic Myeloid Leukemia

Jack W. Erter, III, MD, and Ramiro Garzon, MD

Drs. Erter and Garzon are fellows; both are at the Division of Hematology/Oncology, Comprehensive Care Center, Ohio State University, Columbus, OH.

Question 2

A 42-year-old man previously diagnosed with Philadelphia (Ph) chromosome–positive CP-CML presents for treatment monitoring. Six months ago, the patient was started on imatinib (400 mg/day). At 3-month follow-up, the patient achieved complete hematologic remission. At the current presentation, repeat cytogenetic analysis of the bone marrow is performed, which reveals a decrease in the Ph-positive metaphases from 100% to 20%. However, a novel clonal trisomy 8 abnormality is documented in 5 of 16 Ph-negative metaphases. The bone marrow morphology is normal, and the patient remains in complete hematologic remission. How should this patient be treated?

  •  Change imatinib to dasatinib
  •  Continue with imatinib at the same dose
  •  Increase imatinib to 800 mg/day
  •  Perform allogeneic HSCT as soon as possible

Updated 3/4/2009 • nvf | Copyright ©2009 Turner White Communications