SOHO 2026 | Managing patients with CML and additional genetic abnormalities
Jorge Cortes, MD, The University of Alabama at Birmingham, Birmingham, AL, discusses a key unresolved question in chronic myeloid leukemia (CML): how to manage patients with additional genetic abnormalities at diagnosis, particularly ASXL1 mutations. He emphasizes the need to better understand optimal treatment strategies and the appropriate timing of transplant to improve outcomes in this patient subset. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
Probably the most important question that we have right now is these patients that have additional genetic abnormalities and particularly ASXL1 mutations at the time of diagnosis. It’s not a big subset of patients, maybe about 10%, but we really don’t have good answers as to what’s the optimal management for those patients. How much do you need to continue trying tyrosine kinase inhibitors? When do you bring a transplant? Is there any good strategy for these patients? What do we do? Is there a specific tyrosine kinase inhibitor? I don’t think so...
Probably the most important question that we have right now is these patients that have additional genetic abnormalities and particularly ASXL1 mutations at the time of diagnosis. It’s not a big subset of patients, maybe about 10%, but we really don’t have good answers as to what’s the optimal management for those patients. How much do you need to continue trying tyrosine kinase inhibitors? When do you bring a transplant? Is there any good strategy for these patients? What do we do? Is there a specific tyrosine kinase inhibitor? I don’t think so. Is it combinations? Maybe. But it’s a subset of patients that we really do not understand well. And part of the problem is they’re not that many. Again, it’s only 10% of the patients. And we don’t routinely do next-generation sequencing at baseline. I think we’re starting to do that to generate that data, but it is an important subset of patients that are really very important to focus on more organized approaches to try to understand what it means biologically, but very importantly, how do we translate that into treatment and better outcomes for these patients.
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