Management of chronic myeloid leukaemia patients treated with ponatinib in a real-life setting: A retrospective analysis from the monitoring registries of the Italian Medicines Agency (AIFA)

Real-world data on daily practice management, treatment modifications and outcome of a large cohort of chronic myeloid leukaemia (CML) patients treated with ponatinib was performed through monitoring Registries of the Italian Medicines Agency (AIFA). Overall, 666 CML subjects were included in the ponatinib registry from February 2015 to December 2020 and were eligible for analysis: 515 in chronic phase (CP), 50 in accelerated phase (AP) and 101 in blast crisis (BC). Median age at baseline was 58.7 years with a predominance of male subjects (57.1\%). The median time from diagnosis to start of ponatinib was 2.35 years: 259 (38.9\%) subjects had received two previous lines of treatment, 260 (39.0\%) three lines and 147 (22.1\%) four or more lines. A molecular response {[}from major molecular response (MMR) to a score of <= 0.01\% on the international reporting scale (IS)] was reported for 59\% of patients out of 593 patients analysed. With a median follow-up of 14.4 months, 136 subjects (20.4\%) required at least one dose reduction due to adverse events (AEs), whereas 309 patients (46.4\%) required dose reduction in the absence of any evidence of side effects. Treatment discontinuation occurred in 261 patients (39\%). This real-life analysis shows that dose reductions were made primarily as a precaution rather than due to the occurrence of adverse reactions.