Characteristics and outcomes of patients with chronic myeloid leukemia and T315I mutation treated in the pre- and post-ponatinib era

Patients with chronic myeloid leukemia (CML) and T315I mutation generally have a poor prognosis. Their outcome in the post-ponatinib era remains unclear. We reviewed patients with CML in chronic (CP) or accelerated phase (AP) who developed a T315I mutation between March 15, 2004, and July 26, 2022....

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Published in:American journal of hematology 2023-10, Vol.98 (10), p.1619-1626
Main Authors: Haddad, Fadi G, Sasaki, Koji, Bidikian, Aram, Issa, Ghayas C, Kadia, Tapan, Jain, Nitin, Alvarado, Yesid, Short, Nicholas J, Pemmaraju, Naveen, Loghavi, Sanam, Patel, Keyur P, Kanagal-Shamanna, Rashmi, Yilmaz, Musa, Masarova, Lucia, Jabbour, Elias, Kantarjian, Hagop
Format: Article
Language:English
Subjects:
Chemotherapy
Chronic myeloid leukemia
Drug Resistance, Neoplasm
Enzyme inhibitors
Fusion Proteins, bcr-abl - genetics
Hematology
Humans
Imidazoles - therapeutic use
Leukemia
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - genetics
Medical prognosis
Mutation
Myeloid leukemia
Protein Kinase Inhibitors - therapeutic use
Protein-tyrosine kinase
Pyridazines - therapeutic use
Survival
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Summary:Patients with chronic myeloid leukemia (CML) and T315I mutation generally have a poor prognosis. Their outcome in the post-ponatinib era remains unclear. We reviewed patients with CML in chronic (CP) or accelerated phase (AP) who developed a T315I mutation between March 15, 2004, and July 26, 2022. Patients were divided into CP, AP, or blastic phase (BP) at the time of mutation detection. Overall survival (OS) was defined from the time of mutation detection to the date of death or last follow-up. We identified a total of 107 patients: 54 (51%) in CP, 14 (13%) in AP, and 39 (36%) in BP. One hundred and two patients received subsequent therapy after the T315I mutation was detected. At a median follow-up of 75 months (95% CI, 41-110), the median OS was 49 months (95% CI, 26-73) and the 5-year OS rate was 44%. Patients who were in CML-CP at the time of mutation detection had better survival compared with those in AP or BP, with a median OS of 132, 31, and 6 months, and 5-year OS rates of 70%, 37%, and 10%, respectively (p 
ISSN:0361-8609
1096-8652
1096-8652
DOI:10.1002/ajh.27037