Incidences of Deep Molecular Responses and Treatment-Free Remission in de Novo CP-CML Patients

Autor: Laura Versmée, Emilie Klein, Caroline Lenoir, Fanny Robbesyn, Sandrine Katsahian, Marie-Pierre Fort, Anna Schmitt, Axelle Lascaux, François Lifermann, Gabriel Etienne, Françoise Durrieu, Fontanet Bijou, Francois-Xavier Mahon, Stéphanie Dulucq, C. Fabères, Béatrice Turcq, Samia Madene, Marius Moldovan, Corinne Dagada, Didier Adiko, Frédéric Bauduer
Přispěvatelé: Service d'Hématologie, Institut Bergonié, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Dpt hématologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre Hospitalier Côte Basque, Bayonne, Service de Médecine-Hématologie [CH Robert Boulin], Centre Hospitalier Libourne, Service de Médecine Interne [Dax], Centre Hospitalier de Dax, Service d'Oncologie-Hématologie, Centre hospitalier de Pau, Université Grenoble Alpes - UFR Arts & Sciences Humaines (UGA UFR ARSH), Université Grenoble Alpes (UGA), Service de Médecine Interne et Hématologie, Centre Hospitalier Intercommunal Mont-de-Marsan-Pays des Sources, Service d'Hématologie-Oncologie, Centre Hospitalier de Périgueux, INSERM U1218 ACTION, Université de Bordeaux (UB), Unité de Recherche Clinique et Centre Investigation Clinique-Epidémiologie, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service des maladies du sang, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Groupe Hospitalier Sud, Turcq, Beatrice
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Cancers
Cancers, MDPI, 2020, 12 (9), pp.2521. ⟨10.3390/cancers12092521⟩
Volume 12
Issue 9
Cancers, 2020, 12 (9), pp.2521. ⟨10.3390/cancers12092521⟩
Cancers, Vol 12, Iss 2521, p 2521 (2020)
ISSN: 2072-6694
DOI: 10.3390/cancers12092521⟩
Popis: Background: Tyrosine Kinase Inhibitors (TKIs) discontinuation in patients who had achieved a deep molecular response (DMR) offer now the opportunity of prolonged treatment-free remission (TFR). Patients and Methods: Aims of this study were to evaluate the proportion of de novo chronic-phase chronic myeloid leukemia (CP-CML) patients who achieved a sustained DMR and to identify predictive factors of DMR and molecular recurrence-free survival (MRFS) after TKI discontinuation. Results: Over a period of 10 years, 398 CP-CML patients treated with first-line TKIs were included. Median age at diagnosis was 61 years, 291 (73%) and 107 (27%) patients were treated with frontline imatinib (IMA) or second- or third-generation TKIs (2&ndash
3G TKI), respectively. With a median follow-up of seven years (range, 0.6 to 13.8 years), 182 (46%) patients achieved a sustained DMR at least 24 months. Gender, BCR-ABL1 transcript type, and Sokal and ELTS risk scores were significantly associated with a higher probability of sustained DMR while TKI first-line (IMA vs. 2&ndash
3G TKI) was not. We estimate that 28% of CML-CP would have been an optimal candidate for TKI discontinuation according to recent recommendations. Finally, 95 (24%) patients have entered in a TFR program. MRFS rates at 12 and 48 months were 55.1% (95% CI, 44.3% to 65.9%) and 46.9% (95% CI, 34.9% to 58.9%), respectively. In multivariate analyses, first-line 2&ndash
3G TKIs compared to IMA and TKI duration were the most significant factors of MRFS. Conclusions: Our results suggest that frontline TKIs have a significant impact on TFR in patients who fulfill the selection criteria for TKI discontinuation.
Databáze: OpenAIRE
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