Treatment-Free Remission in Patients With Chronic Myeloid Leukemia Following the Discontinuation of Tyrosine Kinase Inhibitors

Authors

Fadi G Haddad
Koji Sasaki
Ghayas C Issa
Guillermo Garcia-Manero
Farhad Ravandi
Tapan Kadia
Jorge Cortes
Marina Konopleva
Naveen Pemmaraju
Yesid Alvarado
Musa Yilmaz
Gautam Borthakur
Courtney DiNardo
Nitin Jain
Naval Daver
Nicholas J Short
Elias Jabbour
Hagop Kantarjian

Publication Date

7-1-2022

Journal

American Journal of Hematology

Abstract

Tyrosine kinase inhibitors (TKIs) discontinuation in patients with Philadelphia-chromosome-positive chronic myeloid leukemia (Ph-positive CML) is increasingly considered. We aim to evaluate the outcome of patients with CML who discontinued TKIs, and determine the factors associated with differences in the success rates of treatment-free remission (TFR). Patients with Ph-positive CML treated between October 1999 and February 2017 who discontinued therapy were analyzed. A major molecular response (MMR) was defined as BCR-ABL1/ABL1 ratio on the International Scale ≤0.1%. TFR failure was defined as the loss of MMR on any single test. We analyzed TFR rates according to duration and depth of response, and conducted a multivariate analysis for factors associated with loss of MMR. Two-hundred and eighty-four patients were analyzed; 199 patients (70%) electively discontinued TKIs. At a median follow-up of 36 months (95% confidence interval, 32-40) after TKI discontinuation, 53 patients (19%) lost MMR. The estimated 5-year TFR rate was 79%. All but one patient regained MMR after resuming therapy. The estimated 5-year TFR rates were higher with MR

Keywords

Humans, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Protein Kinase Inhibitors, Remission Induction, Treatment Outcome

DOI

10.1002/ajh.26550

PMID

35357036

PMCID

PMC11894569

PubMedCentral® Posted Date

3-11-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes