A 78-year-old man repos anorexia, fatigue, and generally feeling unwell. On examination he has a large spleen, appears pale, and the rest of the examination is normal. His blood count is abnormal; the WBC is 46000/ml with increased mature granulocytes, hemoglobin 9.0 g/dL, and platelets 450,000/mL. Fuher investigations reveal BCR-ABL transcripts. T315I mutation is also seen. What is the drug of choice for this condition?: (A) Bosutinib, (B) Ponatinib, (C) Boezomib, (D) Chlorambucil
Answer is B. All Investigation points towards the diagnosis of CML. Management of CML: Tyrosine kinase inhibitors 1st line: Imatinib 2nd line: Dasatinib Nilotinib Bosutinib (DOC for imatinib resistant CML) 3rd line : Ponatinib DOC for T315I mutation DOC when there is failure of >2 TKIs Allogenic stem cell transplantation for patients who have progressed to blast cell crisis stage.