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Case Reports in Hematology
Volume 2017 (2017), Article ID 6167345, 5 pages
Case Report

Ponatinib as a Valid Alternative Strategy in Patients with Blast Crisis-Chronic Myeloid Leukemia Not Eligible for Allogeneic Stem Cells Transplantation and/or Conventional Chemotherapy: Report of a Case

1Hematology Division, IRCCS Ca’ Granda-Maggiore Policlinico Hospital Foundation and University of Milan, Milan, Italy
2Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology “L. and A. Seragnoli,” University of Bologna, Bologna, Italy

Correspondence should be addressed to Alessandra Iurlo

Received 11 April 2017; Revised 19 June 2017; Accepted 12 July 2017; Published 14 August 2017

Academic Editor: Stephen Langabeer

Copyright © 2017 Cristina Bucelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Currently, imatinib and dasatinib are the only tyrosine-kinase inhibitors approved in the US and Europe for the treatment of blast crisis of chronic myeloid leukemia (BC-CML) at diagnosis, while ponatinib is the only inhibitor used in patients bearing T315I mutation. Here we report the case of a 61-year-old man diagnosed with B-cell lymphoid BC-CML, initially treated with imatinib 800 mg day and then with dasatinib 140 mg day because of intolerance. A complete cytogenetic response (CCyR) was achieved at three months; however, three months later a relapse was observed, and the T315I mutation was detected. Ponatinib 45 mg once daily was then started together with a short course of chemotherapy. Bone marrow evaluation after six months of therapy showed the regaining of CCyR, together with the achievement of a deep molecular response. However, one year from ponatinib start the patient experienced a new disease relapse; he was effectively treated with ponatinib and chemotherapy once again, but in the meanwhile an ischemic stroke was detected. This case report confirms the high efficacy of ponatinib monotherapy in BC-CML patients, representing a valid option for non-allogeneic stem cells transplantation eligible cases and the only one available for those carrying the T315I mutation.