Category: Federal Forum Posters
Purpose: Tyrosine kinase inhibitors (TKI) is the backbone of treating patients with Philadelphia chromosome chronic myeloid leukemia (Ph+CML) and has transformed the outlook for patients with this disease; most of whom can now expect to live a normal lifespan. Studies have shown that these agents can be discontinued or de-escalated in selected population which can entail less adverse effects and cost reduction. The purpose of this project is to identify veterans at the West Palm Beach Veterans Affairs Medical Center (WPB VAMC) with Ph+CML who are potential candidates for discontinuation or de-escalation of their TKIs and its potential cost-savings associated.
Methods: This is a retrospective analysis of the use of imatinib, dasatinib and nilotinib in patients with Ph+CML at the WPB VAMC. We will identify the veterans currently on the aforementioned TKIs for Ph+CML and collect patient baseline characteristics at diagnosis, including age, race, clinical comorbidities, and initial or second-line of therapy. Patients to be included will be at least 18 years of age, in chronic phase of CML, currently on imatinib, dasatinib or nilotinib therapy for at least three years and prior evidence of quantifiable BCR-ABL1 with a stable molecular response for at least two years. Patients receiving more than 400 mg daily of imatinib, 100 mg daily of dasatinib, or 400 mg twice daily of nilotinib, also recipients of bosutinib or ponatinib at any point will be excluded. Lastly, potential savings will be measured by the drug cost and expenses with monthly BCR-Abl PCR test.
Paulo Andre Fernandes– PGY1 Pharmacy Resident, West Palm Beach VA Medical Center, Fort Lauderdale, FL