Discontinuation of Tyrosine Kinase Inhibitor Therapy and Treatment Free Remission (TFR) in Chronic Myeloid Leukemia: Successful Achievement of TFR in More Than Two-Third of Patients in a Real-World Practice.

Autor:	Aleem A; Department of Medicine, Division of Hematology/Oncology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. Electronic address: ameralem@ksu.edu.sa., Shaheen NA; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation., Algahtani F; Department of Medicine, Division of Hematology/Oncology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia., Jamal A; Department of Medicine, Division of Hematology/Oncology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia., Alkhudair N; College of Pharmacy, King Saud University, Riyadh, Saudi Arabia., Alghafis M; Department of Medicine, Division of Hematology/Oncology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia., Iqbal Z; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation; Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al-Ahsa, Saudi Arabia., Siti HWZ; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia., Thomas A; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Center for Trials Research, Cardiff University, Cardiff, United Kingdom., Alahmari B; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation., Salama H; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation., Gmati G; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation; Mid and South Essex NHS Foundation Trust, Broomfield Hospital, Chelmsford, United Kingdom., Alzahrani M; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation., Alhejazi A; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation., Alfayez M; Adult Hematology and Bone Marrow Transplant Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Alrajhi A; Clinical Pharmacy Department, King Fahad Medical City, Riyadh, Saudi Arabia; Department of Pharmacy Practice, College of Pharmacy, Al Faisal University, Riyadh, Saudi Arabi., Marei MA; Adult Hematology and Bone Marrow Transplant Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia., Alaskar A; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; Saudi Society of Blood and Marrow Transplantation; College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al-Ahsa, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2024 Aug 24. Date of Electronic Publication: 2024 Aug 24.
DOI:	10.1016/j.clml.2024.08.006
Abstrakt:	Background: Discontinuation of TKI therapy and treatment-free remission (TFR) have become new goals for chronic-phase chronic myeloid leukemia (CP-CML). The aim of this study was to estimate the TFR post discontinuation of TKI therapy at 3 tertiary-care centers. Patients and Methods: CP-CML patients aged ≥16 years who had an attempt to discontinue TKI therapy till June 2022, were eligible. The collected data included patients' demographics, prognostic score, type and duration of TKI therapy, response dates, relapse dates, response to re-initiation of TKI therapy, and risk factors for relapse. Results: Fifty-five patients (35, 63.6% females) with a median age of 40 (range 16-74) years at diagnosis discontinued therapy. Forty-eight (87.3%) patients received imatinib as first line therapy. Twenty-nine (52.7%) patients were receiving imatinib at the time of TKI-discontinuation. Median time from diagnosis to TKI discontinuation was 86 months (IQR 60;132) and median duration of TKI therapy after achieving DMR was 66 months (IQR 47;114). After a median follow up of 34 (IQR 12;68) months, 15 (27.3%) patients relapsed. Median time to relapse was 5 months (range 2-38). Most of the relapses occurred during the first 6 months except 3 (20%) patients. All the relapsed patients achieved MMR after a median of 3 (range 2-6) months after restarting TKI therapy. None of the patients progressed to advanced-phase. Conclusion: Our experience confirms that discontinuation of TKI therapy in CP-CML patients is feasible and safe in routine clinical practice, and can achieve TFR in more than two-third of carefully selected patients. Competing Interests: Disclosure The authors declare they have no competing financial interest related to this paper. (Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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