Abstract 1940
Background
Few chronic myeloid leukemia (CML) patients may stop responding to tyrosine kinase inhibitors (TKI). On mutational analysis, the most common mutation detected is T315I conferring resistance to all TKIs except ponatinib, availability of which is limited. Management of these patients, in the absence of ponatinib is allogenic hematopoietic stem transplantation. Data on outcomes of the patients with this mutation in the absence these modalities is limited. The present study was planned to study the profile and outcomes of CML patients with T315I mutation treated with hydroxyurea and supportive care.
Methods
Data of CML patients with T315I mutation who failed on imatinib diagnosed between 2004 and 2018 was retrospectively analyzed.
Results
A total of 2162 patients were analyzed. Of these, 312 (14.4%) were imatinib failures. Mutations were seen in 120 (38.5%) patients, of which 45 (37.5%) patients had T315I mutation. Reasons for mutational analysis testing were not attaining MMR at 1 year, loss of molecular response and loss of hematological response in 3(6.7%), 35(77.8%) and 7(15.6%) patients respectively. The median duration from diagnosis to T315I detection was 38 months (range, 6-146). At the time of detection of T315I mutation, CP, AP and BP were detected in 19 (42.2%), 12(26.7%) and 14 (31.1%) patients respectively. At a median follow up of 18 months, 19 patients were alive and 26 patients were dead with a median overall survival (mOS) of 18 months (range, 0-122). mOS of patients with CP, AP and BP were not reached (range, 2-122) 12 (range, 1-81) and 3 (range, 0.3-34) months respectively (p = 0.001). Table.Table: 1096P
Characteristic | N (%) |
---|---|
Median age (years) | 37 (range, 6-60) |
Gender Males Females | 32 13 |
Phase CP AP BP | 35 (77.8) 8 (17.8) 2 (4.4) |
EUTOS risk Low High | 22 (48.9) 23 (51.2) |
Conclusions
T315I was the most common mutation detected in patients who had not attained MMR or progressed on imatinib. Majority of patients were in chronic phase at time of T315I detection. Phase at the time of detection of T315I had significant impact on outcomes in the absence of targeted therapy or allogenic stem cell transplantation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Nizam’s Institute of Medical Sciences.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1728 - A phase III trial evaluating olanzapine 5 mg for the prevention of chemotherapy-induced nausea and vomiting in patients receiving cisplatin: J-FORCE Study
Presenter: Hironobu Hashimoto
Session: Poster Display session 1
Resources:
Abstract
920 - Efficacy of intravenous (IV) NEPA, a fixed NK1/5-HT3 receptor antagonist (RA) combination, for prevention of CINV following cisplatin- and anthracycline cyclophosphamide (AC)-based chemotherapy (CT)
Presenter: Lee Schwartzberg
Session: Poster Display session 1
Resources:
Abstract
5146 - Efficacy of olanzapine combination in prevention of nausea & vomiting in highly emetogenic chemotherapy
Presenter: Smitha Saldanha
Session: Poster Display session 1
Resources:
Abstract
1947 - Patient-reported outcome data during real-world use of NEPA for prevention of chemotherapy-induced nausea and vomiting in high-risk platin-receiving patients - A prospective multicenter trial
Presenter: Meinolf Karthaus
Session: Poster Display session 1
Resources:
Abstract
6163 - A study evaluating steroid induced metabolic syndrome after antiemetic dexamethasone therapy in patients received high emetic risk chemotherapy
Presenter: Hee Jun Kim
Session: Poster Display session 1
Resources:
Abstract
2154 - High incidence of nausea during initial and repeated courses if intravenous chemotherapy in patients receiving guideline consistent antiemetic prophylaxis - a prospective, observational, real world study.
Presenter: Teresa Smit
Session: Poster Display session 1
Resources:
Abstract
1637 - "Randomised controlled trial of Scalp Cooling (SC) for the prevention of Chemotherapy Induced Alopecia (CIA)”
Presenter: Jyoti Bajpai
Session: Poster Display session 1
Resources:
Abstract
5351 - Performance of the ‘4S rule’ to predict short-term outcomes in cancer outpatients with unsuspected pulmonary embolism.
Presenter: David Pesántez Coronel
Session: Poster Display session 1
Resources:
Abstract
1189 - Prevalence of venous thromboembolism based on intensive screening for patients with advanced solid tumor in prospective observational study
Presenter: Shota Omori
Session: Poster Display session 1
Resources:
Abstract
4340 - Short-term outcomes of cancer patients with pulmonary embolism according to the setting (hospital-acquired vs. outpatient) at diagnosis.
Presenter: Diego Muñoz Guglielmetti
Session: Poster Display session 1
Resources:
Abstract