Description:

This session will focus on evidence-based recommendations for managing patients with one of three myeloproliferative disorders – typical BCR/ABL1-positive chronic myeloid leukemia, atypical chronic myeloid leukemia, and chronic neutrophilic leukemia. Characteristic mutations aid in the differential diagnosis of these diseases which may have overlapping clinical features. Molecular monitoring has become the standard for assessment of optimal treatment response.

Dr. Richard Larson will review the emerging 5 and 10 year outcome data from randomized clinical trials evaluating BCR/ABL1 tyrosine kinase inhibitors for treatment of chronic phase CML. He will discuss the predictive value of an early molecular response, guidelines for assessing optimal responses, the recognition and management of early toxicities, and late treatment-related complications such as vascular occlusive events.

Dr. Michael Deininger will discuss current recommendations for molecular monitoring in CML and the potential confusion resulting from different laboratory techniques and reporting standards. Expert advice will be given regarding how to interpret laboratory reports, how to evaluate treatment failures, when to perform sequence analysis for ABL1 kinase mutations, and their clinical implications. He will describe the emerging results from prospective treatment discontinuation studies in CML after achievement of deep molecular remissions.

Dr. Kim-Hien Dao will describe the clinical presentation and pathophysiology of two other myeloproliferative disorders – atypical CML and chronic neutrophil leukemia – that can present diagnostic and therapeutic challenges. She will discuss the role of oncogenic CSF3R mutations in these neoplasms and a potential therapeutic use of inhibitors of JAK kinases.