Combination of axitinib with dasatinib improves the outcome of a chronic myeloid leukemia patient with BCR-ABL1 T315I mutation.

Chronic myeloid leukemia (CML) is one of the most common hematological malignancies and characterized by the formation of Philadelphia (Ph) chromosome. Recently, tyrosine kinase inhibitors (TKI) treatment greatly improved the prognosis of CML. However, the options may be limited when a patient develops traditional TKI resistance or gene mutation. Herein, we reported a case. A 38-year-old male CML patient developed a BCR-ABL1 gene mutation of T315I after 2.5 years of TKI treatment, including imatinib and dasatinib. We adjusted the treatment with the combined application of dasatinib and axitinib. BCR-ABL1 gene copies dropped down and achieved an early molecular response at 2 months later. Subsequently, he received hematopoietic stem cell transplantation. Axitinib and dasatinib were applied for another half year after the allogeneic hematopoietic stem cell transplantation (allo-HSCT). Two years after the allo-HSCT, the BCR-ABL1 gene was still undetectable. It provided a successful example in treating CML patients carrying BCR-ABL1 T315I mutation via combination of axitinib with conditional TKI.慢性粒细胞白血病(chronic myeloid leukemia，CML)是一类以髓系细胞慢性增殖为主要特征的恶性克隆性疾病，大多数患者具有Ph染色体。近年来，酪氨酸激酶抑制剂(tyrosine kinase inhibitors，TKI)治疗CML明显改善了其预后。但当患者发生对传统TKI耐药或基因突变时，可能会限制治疗方案的选择。本文报道1名38岁CML男性患者在接受2.5年的TKI(伊马替尼/达沙替尼)治疗后，出现BCR-ABL1 T315I突变；联合阿西替尼及达沙替尼的方案治疗2个月后，BCR-ABL1拷贝数明显下降，取得理想的治疗效果。患者后续进行造血干细胞移植治疗，移植后仍使用阿西替尼及达沙替尼维持治疗，随访至移植后2年的结果均提示患者BCR-ABL1阴性。本文提供了1个阿西替尼联合现有TKI治疗伴有BCR-ABL1T 315I突变的CML患者的成功实例。.