T315I clone selection in a Ph+ all patient under low‐dose ponatinib maintenance. Issue 8 (3rd July 2017)

• Record Type: Journal Article
• Authors: Noetzli, Jasmine; Gavillet, Mathilde; Masouridi‐Levrat, Stavroula; Duchosal, Michel; Spertini, Olivier
• Is Part Of: Clinical case reports. Volume 5:Issue 8(2017)
• Page Start: 1320
• Page End: 1322
• Publication Date: 2017-07-03
• Subjects: Acute lymphoblastic leukemia -- T315I BCR‐ABL -- treatment maintenance -- tyrosine kinase inhibitor; Medicine -- Periodicals; 616.09
• DOI: 10.1002/ccr3.1032
• Languages: English
• ISSNs: 2050-0904

Abstract

Key Clinical Message: We report here the clinical course of a Ph+ ALL patient who was treated with ponatinib 15 mg/day, as maintenance therapy, and developed a BCR‐ABL T315I mutation leading to ALL relapse. This clonal evolution was reversed, without adverse effects, by increasing ponatinib to 45 mg/day. To our knowledge, we have been confronted with the first clinical case of a T315I clonal selection of ALL caused by subeffective therapeutic level of the drug. This single patient experience highlights the risk of T315I clone selection in Ph+ ALL treated with reduced dose ponatinib. Abstract : We report here the clinical course of a Ph+ ALL patient who was treated with ponatinib 15 mg/day, as maintenance therapy, and developed a BCR‐ABL T315I mutation leading to ALL relapse. This clonal evolution was reversed, without adverse effects, by increasing ponatinib to 45 mg/day. To our knowledge, we have been confronted with the first clinical case of a T315I clonal selection of ALL caused by subeffective therapeutic level of the drug. This single patient experience highlights the risk of T315I clone selection in Ph+ ALL treated with reduced dose ponatinib.