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Diagnosed young versus diagnosed old

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I have viewed the medical presentations for CML Horizons 2019 provided at the link below:

https://cmlsupport.org.uk/article/cml-horizons-2019-presentations-and-vi...

One of the presenters states that young people diagnosed with CML have a quicker rate of progression of the disease compared with those who are diagnosed at age 60+. He said that younger people have a more aggressive CML. The presenter goes on to suggest that younger people are treated with the more potent second-generation TKIs with the hope of bringing about treatment free remission at the earliest possible stage whereas the older patients may be treated with imatinib. He believes that discontinuation is not so appealing for the older age groups.

Has anyone come across other consultants who think along these lines? Is this a standard line of thinking?

Was that Gianantonio? I’ve spoken to him before and that was along the lines of his opinion. 

I did chat with my haematologist about TFR in older patients, and she said that there tended to be less appetite in that cohort to stop or reduce dose. Why exactly hasn’t been studied I believe, but anecdotally younger patients seem to want to be off drugs or lower doses due to perceived long term toxicity. For me it’s also about limiting side effects.

David.