Management of a 75-Year-Old Lady with Refractory Chronic Myelogenous Leukemia

• Published in: Case reports in oncology 2020-05, Vol.13 (2), p.534-537
• Main Authors: Sobash, Philip T., Guddati, Achuta K., Kota, Vamsi
• Format: Article
• Language: English
• Subjects: Biopsy; Blood; Bone marrow; Case Report; Case reports; chronic myelogenous leukemia; complete molecular remission; Drug dosages; Hematology; Inhibitor drugs; Kinases; Leukemia; Literature reviews; major molecular response; Mutation; Patients; refractory; Remission (Medicine); Targeted cancer therapy; tyrosine kinase inhibitors
• ISSN: 1662-6575; 1662-6575
• DOI: 10.1159/000506895

Chronic myelogenous leukemia (CML) is a hematopoietic disorder caused by the BCR/ABL gene or Philadelphia chromosome. The first Food and Drug Administration (FDA)-approved tyrosine kinase inhibitor for treatment of CML was imatinib in 2001. Since then, multiple therapies, such as nilotinib, dasatinib, bosutinib, and, more recently, ponatinib, have made their way as viable treatment options for first-line and secondary therapies. Most patients tend to respond to first-line treatment. Although there is a subset of patients who do not achieve complete molecular response with first line, newer options have proven beneficial. As we progress through therapies, there still remain some patients who do not adequately respond to current available therapies. The treatment options and guidelines become more difficult in such situations, not only with respect to cost but also patient quality of life and satisfaction. We discuss a 75-year-old white female with CML, who has had multiple therapies with hematological remission but has never achieved complete molecular remission, currently on bosutinib and tolerating it well.