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Treatment-Free Remission in Chronic Myeloid Leukemia: Can We Identify Prognostic Factors?
Lucas, Claire Saifullah, Hilbeen H.
Lucas, Claire
Saifullah, Hilbeen H.
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2021-08-19
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Abstract
Following the development of tyrosine kinase inhibitors (TKI), the survival of patients with chronic myeloid leukaemia (CML) drastically improved. With the introduction of these agents, CML is now considered a chronic disease for some patients. Taking into consideration the side effects, toxicity, and high cost, discontinuing TKI became a goal for patients with chronic phase CML. Patients who achieved deep molecular response (DMR) and discontinued TKI, remained in treatment-free remission (TFR). Currently, the data from the published literature demonstrate that 40–60% of patients achieve TFR, with relapses occurring within the first six months. In addition, almost all patients who relapsed regained a molecular response upon retreatment, indicating TKI discontinuation is safe. However, there is still a gap in understanding the mechanisms behind TFR, and whether there are prognostic factors that can predict the best candidates who qualify for TKI discontinuation with a view to keeping them in TFR. Furthermore, the information about a second TFR attempt and the role of gradual de-escalation of TKI before complete cessation is limited. This review highlights the factors predicting success or failure of TFR. In addition, it examines the feasibility of a second TFR attempt after the failure of the first one, and the current guidelines concerning TFR in clinical practice.
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Saifullah, H. H., & Lucas, C. M. (2021). Treatment-free remission in Chronic Myeloid Leukemia: Can we identify prognostic factors?. Cancers, 13(16), 4175. https://doi.org/10.3390/cancers13164175
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MDPI
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Cancers
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2072-6694