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 5

A 32-year-old man with a history of CP-CML that was previously treated with HSCT (matched sibling donor) 3 years ago and who achieved complete cytogenetic and molecular remission presents for his semi-annual follow-up visit. Repeat qRT-PCR analysis of the peripheral blood for BCR-ABL transcripts reveals a 2-log increase with respect to his baseline levels. Cytogenetic analysis of the bone marrow aspirate reveals that 5 of the 20 metaphases assessed are Ph-positive. All of the following are potential treatment options for this patient EXCEPT

  •  Consider a clinical trial
  •  Order a donor lymphocyte infusion (DLI)
  •  Repeat qRT-PCR in 3 months to assess if BCR-ABL
    transcript levels increase
  •  Start treatment with imatinib or dasatinib

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