revumenib — CareFirst (Caremark)
relapsed or refractory acute leukemia with a KMT2A translocation
Initial criteria
- Member has relapsed or refractory acute leukemia with a KMT2A translocation
- Documentation of KMT2A translocation status is provided
Reauthorization criteria
- Member has no evidence of unacceptable toxicity or disease progression while on the current regimen
- Indication remains relapsed or refractory acute leukemia with a KMT2A translocation
Approval duration
12 months