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A 7 8-year-old female patien t presen ts with fatigue and weakness . On physical exam. she has splenomegaly. CBC shows leukocyte count of 1 5 , LJOO/pl with 38% monocytes and 22% eosinophi ls; hemoglobin is 1 0.3 g/d l and platelet count is 1 LJ3.000/pl. The blood smear is depicted below.
Testing for PDGFRB returns positive. What is the most appropriate treatment for this patient?
- Azacitidine
- Daunorubicin with cytarabine
- Etoposide
- Imatinib
- Sunitinib
Medicine
D. Patients with CMML harboring PDGFRB translocations exhibit durable responses with the use of imatinib, which is considered the most appropriate therapy in the nonemergent setting in cases harboring PDGFRB translocations (NEfM. 2002;347(7):48 1, Blood. 2002;100(3):1088, Blood. 2007;109(1 ):61).
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