Is adjuvant treatment required during the recovery period of bone marrow transplantation with ivonib (Tosuvo)?

Ivosidenib is an oral small molecule inhibitor that targets IDH1 mutations. It is mainly used for patients with acute myeloid leukemia who carry IDH1 mutations. The need for continued or combined use of ivonib as adjuvant therapy during the recovery period after bone marrow transplantation generally depends on the patient's risk of relapse, pre-transplant disease status, and post-transplant molecular monitoring results. For patients with minimal residual disease (MRD) or a high risk of recurrence, adjuvant therapy often has certain clinical significance.

In some clinical practices, ivonib can be used as one of the maintenance or adjuvant treatments after transplantation. The purpose is to continuously inhibit the abnormal metabolic pathways related to IDH1 mutations and reduce the possibility of leukemia cells proliferating again. This strategy is more common in patients who respond well to ivonib treatment before transplantation and who still have IDH1 mutation signals after transplantation. However, whether to use it requires a comprehensive evaluation by a hematologist based on the transplant recovery status.

The immune function of patients in the recovery period of bone marrow transplantation has not yet been completely reconstructed. Adjuvant treatment is not limited to anti-leukemia drugs, but may also include anti-infection prevention, immunosuppression adjustment, hematopoietic support, and nutritional management. If ivosidenib is used at this stage, blood levels, liver function and drug interactions need to be closely monitored to avoid adverse effects on hematopoietic reconstruction and organ function.

Generally speaking, ivonib is not an adjuvant treatment drug that all patients must use during the recovery period of bone marrow transplantation. Its application is more inclined to an individualized strategy. For patients with a higher risk of recurrence or whose molecular monitoring suggests potential recurrence, the rational use of ivonib may help consolidate the efficacy of transplantation; for patients with good recovery and low risk, it may not be used temporarily and only close follow-up and observation will be performed.

Keyword tags: ivonib,IDH1inhibitor, acute myeloid leukemia, post-transplantation therapy, adjuvant therapy

Reference:https://reference.medscape.com/drug/tibsovo-ivosidenib-1000240