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How to Treat Chronic Myeloid Leukemia (CML) - Dr. Jorge Cortes


Key point:

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•⁠  ⁠Comprehensive workup, including bone marrow aspiration and cytogenetic analysis, is crucial for optimal CML patient care and risk stratification.
•⁠  ⁠Selection of TKIs for CML should be based on individual patient factors, such as comorbidities and treatment goals, rather than solely on risk stratification scores.
•⁠  ⁠Regular monitoring of treatment response is essential for managing CML patients on TKIs, with the potential for treatment discontinuation in those achieving deep molecular responses.

In this episode of the Oncology Brothers podcast, Dr. Jorge Cortes from the Georgia Cancer Center joined hosts Drs. Rahul and Rohit Gosain to discuss the current standard of care treatment options for Chronic Myeloid Leukemia (CML). Dr. Cortes emphasized the importance of risk stratification in selecting the right treatment for CML patients, highlighting the need for a thorough workup including bone marrow aspiration and cytogenetic analysis.

The conversation delved into monitoring patients on first and second-generation TKIs, emphasizing the significance of achieving deep molecular responses for potential treatment discontinuation. Dr. Cortes also discussed the considerations for switching therapies in cases of resistance or intolerance, mentioning the role of mutations and the potential use of omacetaxine in specific scenarios.

The podcast touched on the side effects associated with different TKIs, including myelosuppression, pleural effusion, gastrointestinal toxicity, and arterial occlusive events. Dr. Cortes provided insights on managing these side effects and the use of prophylactic anticoagulation in high-risk patients.

Overall, the episode provided valuable insights into the treatment landscape of CML, emphasizing personalized approaches based on risk stratification, molecular responses, and side effect profiles. Listeners gained a comprehensive understanding of the considerations involved in managing CML patients effectively.