CML

Question 1

Ph chromosome breakpoints

Answer 1

t(9;22) - Philadelphia

p190 - more ALL
p210 - more CML

(alphabetical)

Question 2

CML major molecular response

Answer 2

<0.1% BCR-ABL or >3 log reduction

Question 3

CML phases

Answer 3

Chronic phase
Accelerated phase: blast 10-30%
Blast phase: blast >30%; 1/3 AML, 2/3 ALL –> HSCT

Question 4

CML TKI options

Answer 4

Imatinib
Dasatinib - faster/deeper remission
NIlotinib - faster/deeper remission
Ponatinib (for T315I mutation or TKI resistance)

all have similar OS

Question 5

TKI s/e

Answer 5

myelosuppression
fluid retention
rash
hepatotoxicity (transaminases)
endocrinopathies

Question 6

CML HSCT criteria

Answer 6

accelerated/blast phase
failure of multiple TKI
unacceptable/intolerable TKI toxicity