63rd ASH Annual Meeting and Exposition
December 11-14, 2021
  • Mechanisms of resistance and expanded therapies
  • Progress with response prediction and TKI discontinuation

632. Chronic Myeloid Leukemia: Clinical and Epidemiological: Mechanisms of resistance and expanded therapies

307 ASH denotes this abstract as clinically relevant

Michael W. Deininger, Jane F Apperley, Christopher Kevin Arthur, et al.

Largely resistant patients achieved high response rates with ponatinib in previous studies. The OPTIC post hoc analysis also demonstrated a clinical benefit with all 3 dosage regimens. This was independent of the T315I mutation status at baseline. Also independently of this, most patients were able to maintain their response after a dose reduction to 15 mg / day when a BCR-ABL1IS ≤ 1% was achieved.
Patients with a baseline T315I mutation were more likely to lose response after dose reduction. When the dose was increased again, this was restored in 6 out of ten patients. For T315I mutations, the PFS at a dose of 45 mg → 15 mg was higher than in other study arms; without T315I mutations, robust PFS and OS results could be demonstrated for all 3 dosage regimens. With their data, the study authors demonstrate the benefit of using ponatinib after 2nd generation TKI for patients with resistant disease. This is independent of the baseline T315I mutation status.


308 ASH denotes this abstract as clinically relevant

Xiaoshuai Zhang, Zongru Li, Yazhen Qin, et al.

The use of the 3rd generation TKI therapy achieves a poor response to ASXL1 mutations with a VAF ≥ 17% and PHF6 mutations. There were also worse results with STAT5A and RUNX1 mutations as well as high-risk ACAs.



Jorge E. Cortes, Tapan Saikia, Dong-Wook Kim, et al.

Vodobatinib in patients with heavily previously treated CML who failed ≥ 3 previous TKIs, including ponatinib, remains beneficial with a long-term safety and efficacy.


310 ASH denotes this abstract as clinically relevant

Michael J. Mauro, Yosuke Minami, Delphine Rea, et al.

After a median follow-up time of 19.2 months, the study authors assume a positive benefit-risk profile of asciminib compared to BOS and recommend the use of asciminib as a new therapy in this heavily pretreated patient population.


311 ASH denotes this abstract as clinically relevant

Jiang Qian, Dayu Shi, Zongru Li, et al.

According to the study authors, olverembatinib is efficacious and well tolerated in TKI-resistant CML-CP or CML-AP and long-term treatment.



Mhairi Copland, Daniel Slade,Graham McIlroy, et al.

Ponatinib can be safely combined with high-dose chemotherapy to bring about a return to the chronic phase in patients with BP-CML, making ponatinib an effective new treatment strategy for these high-risk patients. Patients who respond to therapy and who then undergo alloSCT can benefit from long-term disease-free survival.

632. Chronic Myeloid Leukemia: Clinical and Epidemiological: Progress with response prediction and TKI discontinuation


Koji Sasaki, Elias J. Jabbour, Ghayas C. Issa, et al.

Just as effective as standard-dose dasatinib is low-dose dasatinib, which has fewer intolerances. This results in a favorable outcome.



Xiaoshuai Zhang, Xiaojun Huang, Robert Peter Gale and Qian Jiang.

The predictive score for FFS described by the study authors identifies people with newly diagnosed chronic CML with initially imatinib with different probabilities of success. This should enable doctors to select the best TKI therapy strategy in this setting.

633 ASH denotes this abstract as clinically relevant

Francois-Xavier Mahon, Johan Richter, Andreas Hochhau, et al.

This final analysis of the largest TFR study confirms the MRecFS and MRecTFS rates from the interim analysis. However, late molecular relapse (15% between 6 and 36 months) was observed. Nevertheless, almost half (46%) were still in MRecTFS at 3 years.



Katia B Pagnano, Chung Hoow Kok, Michael J. Mauro, et al.

Older CML patients (> 75 years) with COVID-19 have a higher mortality rate. Likewise for CML / COVID-19 patients with cardiovascular or pulmonary comorbidities and from countries with low and middle income. There were also more deaths in patients in advanced stages and in those without MMR.



Delphine Rea, Slawomira Kyrcz-Krzemien, Paolo Sportoletti, et al.

An additional year of NIL-CONS for CML-CP who achieved a sustained DMR after switching from IM after 2 years with NIL does not bring any significant incremental advantage in terms of TFR success. The efficacy of NIL (300 mg BID) in achieving MR in patients who were unable to achieve sustained DMR with 1st-line IM for ≥ 24 months was confirmed without any new safety signals.



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