Panel recommendations for MLN-TK (WHO/ICC)
| Disease . | Panel recommendations . |
|---|---|
| MLN-TK (WHO/ICC) | In patients with PDGFRA/B-rearranged MLN, both in chronic and blast phases, HCT is only considered after failure of TKI treatment. However, in young patients (<60 y) presenting with blast-phase disease, HCT could be considered on achieving a response. Careful assessment of cardiac and pulmonary function is advised for transplant eligibility and then for tailoring transplant platform HCT, after bridging with an alternative TKI with or without chemotherapy, seems to be the preferred option for the rare cases of MLN-PDGFRA/B with secondary resistance to imatinib HCT with donor search should be considered early after diagnosis for most eligible patients with FGFR1-, JAK2-, ABL1-, and FLT3-rearranged MLN, given the low predictability and uncertain durability of responses to TKIs TKI treatment directed to the specific molecular abnormality is recommended to decrease disease burden pre-HCT A thorough evaluation of cardiac and pulmonary function is essential, given the possible organ impairment associated with prior/ongoing eosinophilic infiltration The HCT strategy should be tailored to the predominant clinical features of the disease (ie, AML, ALL, or MPN) Monitoring of the underlying molecular abnormality using sensitive techniques is advised to inform treatment strategies to prevent overt disease relapse The role of TKI maintenance after HCT warrants investigation |
| Disease . | Panel recommendations . |
|---|---|
| MLN-TK (WHO/ICC) | In patients with PDGFRA/B-rearranged MLN, both in chronic and blast phases, HCT is only considered after failure of TKI treatment. However, in young patients (<60 y) presenting with blast-phase disease, HCT could be considered on achieving a response. Careful assessment of cardiac and pulmonary function is advised for transplant eligibility and then for tailoring transplant platform HCT, after bridging with an alternative TKI with or without chemotherapy, seems to be the preferred option for the rare cases of MLN-PDGFRA/B with secondary resistance to imatinib HCT with donor search should be considered early after diagnosis for most eligible patients with FGFR1-, JAK2-, ABL1-, and FLT3-rearranged MLN, given the low predictability and uncertain durability of responses to TKIs TKI treatment directed to the specific molecular abnormality is recommended to decrease disease burden pre-HCT A thorough evaluation of cardiac and pulmonary function is essential, given the possible organ impairment associated with prior/ongoing eosinophilic infiltration The HCT strategy should be tailored to the predominant clinical features of the disease (ie, AML, ALL, or MPN) Monitoring of the underlying molecular abnormality using sensitive techniques is advised to inform treatment strategies to prevent overt disease relapse The role of TKI maintenance after HCT warrants investigation |