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Talha Badar/X

Oct 27, 2024, 17:31

CML review series with Talha Badar

Talha Badar, Hematology Oncology specialist at Mayo Clinic, shared on X:

“Continuing CML review series.

Brief overview of CML in blast phase (CML-BP).

CML-BP continues to have a dismal outcome in the TKI-era with median OS of 12 months.

Outcome of patients are better with:
-TKI based treatment combination.
-Lymphoid blast phase.
-Allo-HCT in CR1.
Recently, WHO recommended eliminated CML-AP and categorizing CML: CML-CP and CML-BP (Khoury et al. Leukemia 2022)

CML review series with Talha Badar

Genomic landscape of CML-BP

Study comprehensively evaluated genomic profile of 136 CML-BP and 148 CML-CP samples by exome/target sequencing (Ochi et al. Nature Communications 2021)

Data showed differential 2/ profile in LBP, MBP and with prior TKI therapy.

Genetic alterations were more predictive of outcome rather than clinical variables.

CML review series with Talha Badar

Management of CML-BP: Intensive vs non-intensive.

MATCHPOINT (PI-PII): FLAG-IDA plus ponatinib (30 mg). ORR (11/17) 65%; 5 pt MMR. 12/17 (70%) bridge to alloHCT (Copland et al. Lancet Hematol 2022)
mOS=12 mo (Image 1) . 10 (59%) died, median f/u 41 mo.

PII study decitabine (20 mg/m2 D8-12)+ venetoclax (D8-D28) and ponatinib (45 mg OD/D1-7) in 20 pts with CML-BP . ORR 80% (CR/CRi 50%), mOS= 11.1 months (Image 2) (Short et al. Lancet Hematol 2024)

CML review series with Talha Badar

CML-BP: European LeukemiaNet blast phase registry

Larger registry dataset, including high risk CML-CP. mOS 23.8 mo, outcomes were better in CML-LBP vs MBP. Allo-HCT associated with DMR. Brioli et al. Leukemia 2024

CML review series with Talha Badar
CML-BP, outcome with allo-HCT: Mayo Clinic experience

•We looked at allo-HCT outcome among 59 patients with CML-BP.
•20 (34%) MBP, 24 (41%) LBP, 15 (25%) high risk CML-CP.
•3 yrs (70.2%) and 5 yrs (48.6%) survival with allo-HCT.
•Significant better with LBP vs MBP; de novo MBP vs transformed MBP.
•ACA (7/7q-) associated dismal outcome.

Talha Badar

Summary: CML-BP

Overall, continues to have inferior outcome in the TKI-era.

LBP tends to have better outcome compared to MBP.

Intensity of induction therapy does not matter, allo-HCT in CR1 suggestive of better outcome.”

More posts featuring Talha Badar on oncodaily.com

Dr. Talha Badar, MD, is a specialist in Hematology Oncology based in Mayo Clinic, Jacksonville, Florida. His primary areas of expertise include Leukemia, particularly Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome (MDS), Acute Lymphoblastic Leukemia (ALL), and Bone Marrow Transplantation. Over his career, he has actively contributed to clinical research and clinical trials.