{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:29:16Z","timestamp":1790375356742,"version":"4.1.0"},"reference-count":26,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Background and Clinical Significance: Chronic Myeloid Leukemia (CML) management has been revolutionized by tyrosine kinase inhibitors (TKIs), though cardiovascular and thrombotic complications remain a concern, especially in patients with underlying risk factors. Inherited thrombophilia, including protein S deficiency and Factor V Leiden mutation, poses a substantial risk for venous thromboembolism (VTE). Managing CML in patients with such prothrombotic predispositions presents complex therapeutic challenges, particularly in selecting an appropriate TKI and managing anticoagulation. Case Presentation: A 33-year-old woman with congenital thrombophilia (type I protein S deficiency and heterozygous Factor V Leiden mutation) and a history of VTE on long-term anticoagulation with acenocoumarol presented with CML. She exhibited primary resistance to first-line imatinib and poor tolerance with suboptimal response to second-line bosutinib. Third-line treatment with asciminib led to a rapid and sustained major molecular response (MR4.5) without bleeding or thrombotic complications. Conclusions: This case highlights the importance of individualized, multidisciplinary management in CML patients with coexisting thrombophilia. Asciminib, with its favorable cardiovascular safety profile, represents a promising therapeutic option in high-risk patients where other TKIs may be contraindicated due to resistance, intolerance, or thrombotic risk.<\/jats:p>","DOI":"10.3390\/hematolrep17050047","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T10:51:33Z","timestamp":1757933493000},"page":"47","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tyrosine Kinase Inhibitor Treatment of a Patient with Chronic Myeloid Leukemia and Congenital Thrombophilia"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6250-7443","authenticated-orcid":false,"given":"Carol","family":"Herrera-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Hematology Department, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, 35010 Las Palmas, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Segura-Diaz","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, 35010 Las Palmas, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6955-2290","authenticated-orcid":false,"given":"Ruth","family":"Stuckey","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, 35010 Las Palmas, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Francisco","family":"L\u00f3pez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, 35010 Las Palmas, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-5126","authenticated-orcid":false,"given":"Mar\u00eda Teresa","family":"G\u00f3mez-Casares","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario de Gran Canaria Dr. Negr\u00edn, 35010 Las Palmas, Spain"},{"name":"Department of Medical Sciences, University of Las Palmas de Gran Canaria, 35010 Las Palmas, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1182\/blood-2014-09-594432","article-title":"Vascular safety issues in CML patients treated with BCR\/ABL1 kinase inhibitors","volume":"125","author":"Valent","year":"2015","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1182\/bloodadvances.2018025874","article-title":"Analysis of cardiovascular and arteriothrombotic adverse events in chronic-phase CML patients after frontline TKIs","volume":"3","author":"Jain","year":"2019","journal-title":"Blood Adv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1038\/nrcardio.2013.211","article-title":"Inherited risk factors for venous thromboembolism","volume":"11","author":"Martinelli","year":"2014","journal-title":"Nat. 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