Medscape InDiscussion: Chronic Myeloid Leukemia Medscape

Drs Michael J. Mauro and Jane F. Apperley answer key questions about pregnancy and family planning for patients diagnosed with chronic myeloid leukemia, including complications and treatment options.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989029). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Managing Women of Childbearing Age With Chronic Myeloid Leukemia: Safety and Treatment Considerations https://pubmed.ncbi.nlm.nih.gov/37038615/
New Challenges in Human in Vitro Fertilization https://pubmed.ncbi.nlm.nih.gov/8493531/
Treatment of CML in Pregnancy https://pubmed.ncbi.nlm.nih.gov/36485083/
Outcome of Pregnancy in Chronic Myeloid Leukaemia Patients Treated With Tyrosine Kinase Inhibitors: Short Report From a Single Centre https://pubmed.ncbi.nlm.nih.gov/25455655/
Treatment-Free Remission: the New Goal in CML Therapy https://pubmed.ncbi.nlm.nih.gov/34618317/
The Effects of Imatinib on Pregnancy Outcome https://pubmed.ncbi.nlm.nih.gov/18322153/
Stage Specific Requirement of Platelet-Derived Growth Factor Receptor-Α in Embryonic Development https://pubmed.ncbi.nlm.nih.gov/28934221/

Drs Michael J. Mauro and Jerald P. Radich discuss monitoring and diagnostics in chronic myeloid leukemia, including the Philadelphia chromosome and how it plays into the current treatment of CML.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989028). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Chronic Myelogenous Leukemia (CML) https://emedicine.medscape.com/article/199425-overview
Genetics, Philadelphia Chromosome https://www.ncbi.nlm.nih.gov/books/NBK560689/
Reverse Transcriptase-Polymerase Chain Reaction https://emedicine.medscape.com/article/2093395-overview
Why Is It Critical to Achieve a Deep Molecular Response in Chronic Myeloid Leukemia? https://pubmed.ncbi.nlm.nih.gov/33054104/
Precision Oncology: Who, How, What, When, and When Not? https://ascopubs.org/doi/full/10.1200/EDBK_174176
Discovery of the Philadelphia Chromosome: A Personal Perspective https://pubmed.ncbi.nlm.nih.gov/17671636/
Dr. Janet Davison Rowley https://cfmedicine.nlm.nih.gov/physicians/biography_282.html
Metaphase https://www.genome.gov/genetics-glossary/Metaphase
A Primer on Genetic Testing https://www.medscape.com/viewarticle/505220_7
WHO 2016 Definition of Chronic Myeloid Leukemia and Tyrosine Kinase Inhibitors https://pubmed.ncbi.nlm.nih.gov/31612694/
Flow Cytometry: An Overview https://pubmed.ncbi.nlm.nih.gov/29512141/
Accelerated Phase Chronic Myelogenous Leukemia https://www.cancer.gov/publications/dictionaries/cancer-terms/def/accelerated-phase-chronic-myelogenous-leukemia
Treatment-Free Remission in CML: Who, How, and Why? https://pubmed.ncbi.nlm.nih.gov/29222243/
Digital PCR for BCR-ABL1 Quantification in CML: Current Applications in Clinical Practice https://pubmed.ncbi.nlm.nih.gov/33283168/
Tyrosine Kinase Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK563322/
t(14;18) Translocations and Risk of Follicular Lymphoma https://pubmed.ncbi.nlm.nih.gov/18648003/
CHIP https://www.cancer.gov/publications/dictionaries/genetics-dictionary/def/chip
The Max Foundation https://themaxfoundation.org/
BCR-ABL Fusion Gene https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bcr-abl-fusion-gene

Drs Michael J. Mauro and Michael W. Deininger discuss the evolution of chronic myeloid leukemia, better access to treatment, improved global cure rates, and a clearer definition of the word cure.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989027). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Efficacy and Safety of a Specific Inhibitor of the BCR-ABL Tyrosine Kinase in Chronic Myeloid Leukemia https://pubmed.ncbi.nlm.nih.gov/11287972/
A Phase 2 Study of Imatinib in Patients With Relapsed or Refractory Philadelphia Chromosome-positive Acute Lymphoid Leukemias https://pubmed.ncbi.nlm.nih.gov/12200353/
International CML Foundation https://www.cml-foundation.org/
Resistance to Imatinib: Mechanisms and Management https://pubmed.ncbi.nlm.nih.gov/16316612/
Ponatinib Dose-ranging Study in Chronic-phase Chronic Myeloid Leukemia: A Randomized, Open-label Phase 2 Clinical Trial https://pubmed.ncbi.nlm.nih.gov/34407543/
Asciminib Monotherapy in Patients With CML-CP Without BCR::ABL1 T315I Mutations Treated With at Least Two Prior TKIs: 4-year Phase 1 Safety and Efficacy Results https://pubmed.ncbi.nlm.nih.gov/36949155/
Cardiotoxicity of the BCR-ABL1 Tyrosine Kinase Inhibitors: Emphasis on Ponatinib https://pubmed.ncbi.nlm.nih.gov/32470534/
A Kinase Inhibitor Which Specifically Targets the ABL Myristate Pocket (STAMP), but Unlike Asciminib Crosses the Blood-brain Barrier https://pubmed.ncbi.nlm.nih.gov/35065232/
Olverembatinib (HQP1351), a Well-tolerated and Effective Tyrosine Kinase Inhibitor for Patients With T315I-mutated Chronic Myeloid Leukemia: Results of an Open-label, Multicenter Phase 1/2 Trial https://pubmed.ncbi.nlm.nih.gov/35982483/

Drs Michael J. Mauro and Jorge E. Cortes discuss developments in the therapeutic landscape of chronic myeloid leukemia, complexities of resistance, and the potential for treatment-free remission.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989026). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Chronic Myelogenous Leukemia (CML) https://emedicine.medscape.com/article/199425-overview
Tyrosine Kinase Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK563322/
Chronic Myelogenous Leukemia (CML) Treatment Protocols https://emedicine.medscape.com/article/2005453-overview
Monitoring Molecular Response in Chronic Myeloid Leukemia https://pubmed.ncbi.nlm.nih.gov/20960522/
Accelerated Phase Chronic Myelogenous Leukemia https://www.cancer.gov/publications/dictionaries/cancer-terms/def/accelerated-phase-chronic-myelogenous-leukemia
The 5th Edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms https://pubmed.ncbi.nlm.nih.gov/35732831/
International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: Integrating Morphologic, Clinical, and Genomic Data https://pubmed.ncbi.nlm.nih.gov/35767897/
International Chronic Myeloid Leukemia Foundation https://www.cml-foundation.org/
Sokal Score for CML https://reference.medscape.com/calculator/559/sokal-score-for-cml
Treatment-Free Remission: The New Goal in CML Therapy https://pubmed.ncbi.nlm.nih.gov/34618317/
Hematopoietic Stem Cell Transplantation (HSCT) https://emedicine.medscape.com/article/208954-overview
Imatinib (Rx) https://reference.medscape.com/drug/gleevec-imatinib-342239
BCR-ABL Fusion Gene https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bcr-abl-fusion-gene
Ph-like Acute Lymphoblastic Leukemia https://pubmed.ncbi.nlm.nih.gov/28972016/
Next-Generation Sequencing for BCR-ABL1 Kinase Domain Mutation Testing in Patients With Chronic Myeloid Leukemia: A Position Paper https://pubmed.ncbi.nlm.nih.gov/31801582/
ASXL1 Gene https://medlineplus.gov/genetics/gene/asxl1/
Asciminib https://reference.medscape.com/drug/scemblix-asciminib-4000255
The Specificity of Asciminib, a Potential Treatment for Chronic Myeloid Leukemia, as a Myristate-Pocket Binding ABL Inhibitor and Analysis of Its Interactions With Mutant Forms of BCR-ABL1 Kinase https://pubmed.ncbi.nlm.nih.gov/33096322/
ATP-Competitive Inhibitors Modulate the Substrate Binding Cooperativity of a Kinase by Altering Its Conformational Entropy https://pubmed.ncbi.nlm.nih.gov/35905186/
Ponatinib (Rx) https://reference.medscape.com/drug/iclusig-ponatinib-999800

Drs Michael J. Mauro and Ehab Atallah discuss current chronic myeloid leukemia research, where the US stands in comparison with the world, and the important work being conducted by the Cure CML Consortium.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989025). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Chronic Myelogenous Leukemia (CML) https://emedicine.medscape.com/article/199425-overview
Tyrosine Kinase Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK563322/
BCR-ABL Fusion Gene https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bcr-abl-fusion-gene
Trastuzumab/Hyaluronidase (Rx) https://reference.medscape.com/drug/herceptin-hylecta-trastuzumab-hyaluronidase-1000345
H. Jean Khoury Cure CML Consortium https://curecml.org/
Genetics, Philadelphia Chromosome https://www.ncbi.nlm.nih.gov/books/NBK560689/
National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER). Cancer Stat Facts: Leukemia — Chronic Myeloid Leukemia (CML) https://seer.cancer.gov/statfacts/html/cmyl.html
Assessment of Outcomes After Stopping Tyrosine Kinase Inhibitors Among Patients With Chronic Myeloid Leukemia: A Nonrandomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/33180106/
Treatment-free Remission: The New Goal in CML Therapy https://pubmed.ncbi.nlm.nih.gov/34618317/
Monitoring Molecular Response in Chronic Myeloid Leukemia https://pubmed.ncbi.nlm.nih.gov/20960522/
Protocol Number: HJKC3-0003. Treatment Free Remission After Combination Therapy With Asciminib (ABL001) Plus Imatinib in Chronic Phase Chronic Myeloid Leukemia (CP-CML) Patients Who Relapsed After a Prior Attempt at TKI Discontinuation https://clinicaltrials.gov/ct2/show/NCT04838041
Asciminib https://reference.medscape.com/drug/scemblix-asciminib-4000255
Treatment Free Remission After Combination Therapy With Ruxolitinib Plus Tyrosine Kinase Inhibitors https://clinicaltrials.gov/ct2/show/NCT03610971
Ruxolitinib (Rx) https://reference.medscape.com/drug/jakafi-ruxolitinib-999703
Asciminib as Initial Therapy for Patients With Chronic Myeloid Leukemia in Chronic Phase https://clinicaltrials.gov/ct2/show/NCT05143840
ATP-competitive Inhibitors Modulate the Substrate Binding Cooperativity of a Kinase by Altering Its Conformational Entropy https://pubmed.ncbi.nlm.nih.gov/35905186/
The Specificity of Asciminib, a Potential Treatment for Chronic Myeloid Leukemia, as a Myristate-pocket Binding ABL Inhibitor and Analysis of Its Interactions With Mutant Forms of BCR-ABL1 Kinase https://pubmed.ncbi.nlm.nih.gov/33096322/
Ponatinib (Rx) https://reference.medscape.com/drug/iclusig-ponatinib-999800
Accelerated Phase Chronic Myelogenous Leukemia https://www.cancer.gov/publications/dictionaries/cancer-terms/def/accelerated-phase-chronic-myelogenous-leukemia
Acute Myeloid Leukemia https://emedicine.medscape.com/article/197802-overview
Patients' Perspectives on the Definition of Cure in Chronic Myeloid Leukemia https://pubmed.ncbi.nlm.nih.gov/30955853/
International Chronic Myeloid Leukemia Foundation https://www.cml-foundation.org/

Drs Michael J. Mauro and Hagop Kantarjian discuss the cost of chronic myeloid leukemia therapy, long-term safety, adverse events, and the financial toxicity to the patient and the healthcare system.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/989022). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Chronic Myelogenous Leukemia (CML) https://emedicine.medscape.com/article/199425-overview
Influence of the 'Mark Cuban Effect' on Cancer Drug Prices in the United States: Focus on CML https://ascopost.com/issues/february-10-2023/influence-of-the-mark-cuban-effect-on-cancer-drug-prices-in-the-united-states-focus-on-cml/
Response and Resistance to BCR-ABL1-targeted Therapies https://pubmed.ncbi.nlm.nih.gov/32289275/
Imatinib (Rx) https://reference.medscape.com/drug/gleevec-imatinib-342239
Tyrosine Kinase Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK563322/
National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER). Cancer Stat Facts: Leukemia — Chronic Myeloid Leukemia (CML) https://seer.cancer.gov/statfacts/html/cmyl.html
Management of Chronic Myeloid Leukemia in 2023 - Common Ground and Common Sense https://pubmed.ncbi.nlm.nih.gov/37088793/
Assessment of Imatinib as First-line Treatment of Chronic Myeloid Leukemia: 10-year Survival Results of the Randomized CML Study IV and Impact of Non-CML Determinants https://pubmed.ncbi.nlm.nih.gov/28804124/
Toxicities of Receptor Tyrosine Kinase Inhibitors in Cancer Pharmacotherapy: Management With Clinical Pharmacology https://pubmed.ncbi.nlm.nih.gov/28059038/
Dasatinib (Rx) https://reference.medscape.com/drug/sprycel-dasatinib-342199
Nilotinib (Rx) https://reference.medscape.com/drug/tasigna-nilotinib-342198
Ponatinib (Rx) https://reference.medscape.com/drug/iclusig-ponatinib-999800
Asciminib https://reference.medscape.com/drug/scemblix-asciminib-4000255
Treatment-free Remission: The New Goal in CML Therapy https://pubmed.ncbi.nlm.nih.gov/34618317/
Monitoring Molecular Response in Chronic Myeloid Leukemia https://pubmed.ncbi.nlm.nih.gov/20960522/
Cost Plus Drugs https://costplusdrugs.com/
U.S. Health Care From a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022