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Blanco Sánchez A, Gil Manso R, Carreño-Tarragona G, Paredes Ruiz D, González Olmedo J, Martínez-López J, Díaz Pedroche C, Ayala R. Multidisciplinary management in chronic myeloid leukemia improves cardiovascular risk measured by SCORE. Front Pharmacol 2023; 14:1206893. [PMID: 37538175 PMCID: PMC10394626 DOI: 10.3389/fphar.2023.1206893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction: Cardiovascular events are one of the main long-term complications in patients with chronic myeloid leukemia (CML) receiving treatment with tyrosine kinase inhibitors (TKIs). The proper choice of TKI and the adequate management of risk factors may reduce cardiovascular comorbidity in this population. Methods: This study evaluated the cardiovascular risk of a cohort of patients with CML at diagnosis and after follow-up in a specialized cardiovascular risk consultation. In order to do this, we performed data analysis from 35 patients who received TKIs and were referred to the aforementioned consultation between 2015 and 2018 at our center. Cardiovascular risk factors were analyzed separately, as well as integrated into the cardiovascular SCORE, both at diagnosis and at the last visit to the specialized consultation. Results: At the time of diagnosis, 60% had some type of risk factor, 20% had a high or very high risk SCORE, 40% had an intermediate risk, and 40% belonged to the low risk category. During follow-up, the main cardiovascular adverse event observed was hypertension (diagnosed in 8 patients, 23%). 66% of patients quit smoking, achieving control of blood pressure in 95%, diabetes in 50%, weight in 76%, and dyslipidemia in 92%. 5.7% of patients suffered a thrombotic event and a significant percentage of patients showed a reduction in their SCORE. Conclusion: Our study shows the benefit of controlling cardiovascular risk factors through follow-up in a specialized consultation for patients with CML treated with TKI.
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Affiliation(s)
| | - Rodrigo Gil Manso
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Diana Paredes Ruiz
- Department of Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | - Rosa Ayala
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Cheng F, Xu Q, Li Q, Cui Z, Li W, Zeng F. Adverse reactions after treatment with dasatinib in chronic myeloid leukemia: Characteristics, potential mechanisms, and clinical management strategies. Front Oncol 2023; 13:1113462. [PMID: 36814818 PMCID: PMC9939513 DOI: 10.3389/fonc.2023.1113462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023] Open
Abstract
Dasatinib, a second-generation tyrosine kinase inhibitor, is recommended as first-line treatment for patients newly diagnosed with chronic myeloid leukemia (CML) and second-line treatment for those who are resistant or intolerant to therapy with imatinib. Dasatinib is superior to imatinib in terms of clinical response; however, the potential pulmonary toxicities associated with dasatinib, such as pulmonary arterial hypertension and pleural effusion, may limit its clinical use. Appropriate management of dasatinib-related severe events is important for improving the quality of life and prognosis of patients with CML. This review summarizes current knowledge regarding the characteristics, potential mechanisms, and clinical management of adverse reactions occurring after treatment of CML with dasatinib.
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Affiliation(s)
- Fang Cheng
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, China
| | - Qiling Xu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, China
| | - Qiang Li
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, China
| | - Zheng Cui
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, China
| | - Weiming Li
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Weiming Li, ; Fang Zeng,
| | - Fang Zeng
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, China,*Correspondence: Weiming Li, ; Fang Zeng,
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Nouri N, Mehrzad V, Khalaj Z, Zaker E, Zare F, Abbasi E, Khosravi M, Kalantar SM, Salehi M. Effects of ABCG2 C421A and ABCG2 G34A genetic polymorphisms on clinical outcome and response to imatinib mesylate, in Iranian chronic myeloid leukemia patients. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2023. [DOI: 10.1186/s43042-022-00379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
Background
Chronic myeloid leukemia (CML) is a multifactorial clonal myeloid neoplasm that mainly arises from the Philadelphia chromosome. Even though imatinib mesylate (IM) is considered the gold standard for first-line treatment, a number of CML patients have shown IM resistance that can be influenced by many factors, including pharmacogenetic variability. The present study examined whether two common single nucleotide polymorphisms (SNPs) of ABCG2 (G34A and C421A) contribute to IM resistance and/or good responses.
Material and methods
A total of 72 CML patients were genotyped with high-resolution melting (HRM) and restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). We also determined the cytogenetic and hematological response, as evaluable factors for measuring response to imatinib.
Results
In the current study, we explored the relationship between the different variants of ABCG2 G34A and C421A and clinical response to imatinib among CML patients. There were no statistically significant differences between genotypes of C421A and G34A and allele frequencies among the resistant and responder groups, with response to IM (P > 0.05). Also, we found no statistically significant association between genotypes and cytogenetic and hematological responses.
Conclusion
This is the first study to investigate the association between genotypes of the G34A and C421A SNPs and the outcome of IM treatment in Iranian population. As a whole, genotyping of these SNPs is unhelpful in predicting IM response in CML patients.
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Validation of a Mathematical Model Describing the Dynamics of Chemotherapy for Chronic Lymphocytic Leukemia In Vivo. Cells 2022; 11:cells11152325. [PMID: 35954169 PMCID: PMC9367352 DOI: 10.3390/cells11152325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Abstract
In recent years, mathematical models have developed into an important tool for cancer research, combining quantitative analysis and natural processes. We have focused on Chronic Lymphocytic Leukemia (CLL), since it is one of the most common adult leukemias, which remains incurable. As the first step toward the mathematical prediction of in vivo drug efficacy, we first found that logistic growth best described the proliferation of fluorescently labeled murine A20 leukemic cells injected in immunocompetent Balb/c mice. Then, we tested the cytotoxic efficacy of Ibrutinib (Ibr) and Cytarabine (Cyt) in A20-bearing mice. The results afforded calculation of the killing rate of the A20 cells as a function of therapy. The experimental data were compared with the simulation model to validate the latter’s applicability. On the basis of these results, we developed a new ordinary differential equations (ODEs) model and provided its sensitivity and stability analysis. There was excellent accordance between numerical simulations of the model and results from in vivo experiments. We found that simulations of our model could predict that the combination of Cyt and Ibr would lead to approximately 95% killing of A20 cells. In its current format, the model can be used as a tool for mathematical prediction of in vivo drug efficacy, and could form the basis of software for prediction of personalized chemotherapy.
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da Cruz SS, Seabra AD, Macambira LHR, Carneiro DM, Nunes PF, Pontes TB, Mello-Junior FAR, Leão LBC, Cordeiro FDNCDS, Carneiro TX, Moreira-Nunes CA, Burbano RMR. Chronic Myelogenous Leukemia with Double Philadelphia Chromosome and Coexpression of p210 and p190 Fusion Transcripts. Genes (Basel) 2022; 13:580. [PMID: 35456386 PMCID: PMC9025354 DOI: 10.3390/genes13040580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022] Open
Abstract
The Philadelphia (Ph+) chromosome, t(9;22)(q34;q11.2), originates from a chimeric gene called BCR-ABL and is present in more than 90% of CML patients. Most patients with CML express the protein p210 BCR-ABL and, with a frequency lower than 5%, express rare isoforms, the main one being p190. In the transition from the chronic phase to the blast phase (BP), additional chromosomal abnormalities, such as the presence of the double Ph+ chromosome, are revealed. Of the 1132 patients analyzed via molecular biology in this study, two patients (0.17%) showed the co-expression of the p210 and p190 isoforms for the BCR-ABL transcript, with the concomitant presence of a double Ph+ chromosome, which was observed via conventional cytogenetics and confirmed by fluorescent in situ hybridization. The BCR-ABL/ABL% p210 and p190 ratio increased in these two patients from diagnosis to progression to blast crisis. To our knowledge, this is the first report in the literature of patients who co-expressed the two main BCR-ABL transcript isoforms and concomitantly presented Ph+ chromosome duplication. The evolution from the chronic phase to BP often occurs within 5 to 7 years, and, in this study, the evolution to BP was earlier, since disease-free survival was on average 4.5 months and overall survival was on average 9.5 months. The presence of the p190 transcript and the double Ph+ chromosome in CML may be related to the vertiginous progression of the disease.
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Affiliation(s)
- Samara Silveira da Cruz
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
- Human Cytogenetics Laboratory, Biological Science Institute, Federal University of Pará, Belém 66075-110, Brazil
| | - Aline Damasceno Seabra
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
| | - Lais Helena Rescinho Macambira
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
| | - Débora Monteiro Carneiro
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
| | - Patrícia Ferreira Nunes
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
| | - Thais Brilhante Pontes
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
| | - Fernando Augusto Rodrigues Mello-Junior
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
| | - Lucyana Barbosa Cardoso Leão
- Department of Hematology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (L.B.C.L.); (F.d.N.C.d.S.C.); (T.X.C.)
| | | | - Thiago Xavier Carneiro
- Department of Hematology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (L.B.C.L.); (F.d.N.C.d.S.C.); (T.X.C.)
| | - Caroline Aquino Moreira-Nunes
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
- Pharmacogenetics Laboratory, Department of Medicine, Drug Research and Development Center (NPDM), Federal University of Ceará, Fortaleza 60430-275, Brazil
- Northeast Biotechnology Network (RENORBIO), Itaperi Campus, Ceará State University, Fortaleza 60740-903, Brazil
| | - Rommel Mario Rodríguez Burbano
- Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém 66063-240, Brazil; (S.S.d.C.); (A.D.S.); (L.H.R.M.); (D.M.C.); (P.F.N.); (T.B.P.); (F.A.R.M.-J.); (R.M.R.B.)
- Human Cytogenetics Laboratory, Biological Science Institute, Federal University of Pará, Belém 66075-110, Brazil
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Schwarz A, Roeder I, Seifert M. Comparative Gene Expression Analysis Reveals Similarities and Differences of Chronic Myeloid Leukemia Phases. Cancers (Basel) 2022; 14:cancers14010256. [PMID: 35008420 PMCID: PMC8750437 DOI: 10.3390/cancers14010256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 12/25/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a slowly progressing blood cancer that primarily affects elderly people. Without successful treatment, CML progressively develops from the chronic phase through the accelerated phase to the blast crisis, and ultimately to death. Nowadays, the availability of targeted tyrosine kinase inhibitor (TKI) therapies has led to long-term disease control for the vast majority of patients. Nevertheless, there are still patients that do not respond well enough to TKI therapies and available targeted therapies are also less efficient for patients in accelerated phase or blast crises. Thus, a more detailed characterization of molecular alterations that distinguish the different CML phases is still very important. We performed an in-depth bioinformatics analysis of publicly available gene expression profiles of the three CML phases. Pairwise comparisons revealed many differentially expressed genes that formed a characteristic gene expression signature, which clearly distinguished the three CML phases. Signaling pathway expression patterns were very similar between the three phases but differed strongly in the number of affected genes, which increased with the phase. Still, significant alterations of MAPK, VEGF, PI3K-Akt, adherens junction and cytokine receptor interaction signaling distinguished specific phases. Our study also suggests that one can consider the phase-wise CML development as a three rather than a two-step process. This is in accordance with the phase-specific expression behavior of 24 potential major regulators that we predicted by a network-based approach. Several of these genes are known to be involved in the accumulation of additional mutations, alterations of immune responses, deregulation of signaling pathways or may have an impact on treatment response and survival. Importantly, some of these genes have already been reported in relation to CML (e.g., AURKB, AZU1, HLA-B, HLA-DMB, PF4) and others have been found to play important roles in different leukemias (e.g., CDCA3, RPL18A, PRG3, TLX3). In addition, increased expression of BCL2 in the accelerated and blast phase indicates that venetoclax could be a potential treatment option. Moreover, a characteristic signaling pathway signature with increased expression of cytokine and ECM receptor interaction pathway genes distinguished imatinib-resistant patients from each individual CML phase. Overall, our comparative analysis contributes to an in-depth molecular characterization of similarities and differences of the CML phases and provides hints for the identification of patients that may not profit from an imatinib therapy, which could support the development of additional treatment strategies.
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Affiliation(s)
- Annemarie Schwarz
- Institute for Medical Informatics and Biometry (IMB), Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, D-01307 Dresden, Germany; (A.S.); (I.R.)
| | - Ingo Roeder
- Institute for Medical Informatics and Biometry (IMB), Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, D-01307 Dresden, Germany; (A.S.); (I.R.)
- National Center for Tumor Diseases (NCT), D-01307 Dresden, Germany: German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, D-01307 Dresden, Germany; Helmholtz-Zentrum Dresden—Rossendorf (HZDR), D-01328 Dresden, Germany
| | - Michael Seifert
- Institute for Medical Informatics and Biometry (IMB), Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, D-01307 Dresden, Germany; (A.S.); (I.R.)
- National Center for Tumor Diseases (NCT), D-01307 Dresden, Germany: German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, D-01307 Dresden, Germany; Helmholtz-Zentrum Dresden—Rossendorf (HZDR), D-01328 Dresden, Germany
- Correspondence:
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Prenggono MD, Yasmina A, Ariyah M, Wanahari TA, Hasrianti N. The effect of imatinib and nilotinib on blood calcium and blood potassium levels in chronic myeloid leukemia patients: a literature review. Oncol Rev 2021; 15:547. [PMID: 34976304 PMCID: PMC8649642 DOI: 10.4081/oncol.2021.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/27/2021] [Indexed: 11/24/2022] Open
Abstract
Imatinib and nilotinib are first-line treatments for chronic myeloid leukemia (CML) patients, which act specifically against target cells. However, these drugs may cause side effects, such as electrolyte disturbances. This literature review aimed to provide a comparison of the effects of imatinib and nilotinib on blood potassium and calcium levels. It also summarized their hypothetical mechanism. A comprehensive electronic search of the different databases was conducted using ‘chronic myeloid leukemia’, ‘tyrosine kinase inhibitors’, ‘imatinib’, ‘nilotinib’, ‘potassium’, ‘calcium’, ‘electrolytes’ as keywords. This review used PubMed- MEDLINE, Cochrane Library, and Google Scholar as the source databases. Sixteen articles published from 2006 to 2020 were reviewed. Changes in blood potassium levels range from increased to decreased levels, while changes in blood calcium levels range from the lower normal values to below normal values (hypocalcemia). Tyrosine kinase inhibitors (TKIs), including imatinib and nilotinib, have a non-specific target, namely plateletderived growth factor receptor (PDGFR), which indirectly affects blood potassium and calcium levels in CML patients. The clinical manifestations of these changes vary from being visible only in laboratory tests to displaying a variety of clinical signs and symptoms.
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Affiliation(s)
- Muhammad Darwin Prenggono
- Division of Medical Oncology-Hematology, Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin General Hospital, Banjarmasin
| | - Alfi Yasmina
- Department of Pharmacology, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin
| | - Misna Ariyah
- Medical Education Study Program, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin
| | - Tenri Ashari Wanahari
- Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin General Hospital, Banjarmasin, Indonesia
| | - Nuvita Hasrianti
- Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin General Hospital, Banjarmasin, Indonesia
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Cayssials E, Torregrosa-Diaz J, Gallego-Hernanz P, Tartarin F, Systchenko T, Maillard N, Desmier D, Machet A, Fleck E, Corby A, Motard C, Denis G, Herbelin A, Gombert JM, Roy L, Ragot S, Leleu X, Guilhot F, Chomel JC. Low-dose tyrosine kinase inhibitors before treatment discontinuation do not impair treatment-free remission in chronic myeloid leukemia patients: Results of a retrospective study. Cancer 2020; 126:3438-3447. [PMID: 32459375 DOI: 10.1002/cncr.32940] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/17/2020] [Accepted: 04/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Long-term treatment-free remission (TFR) represents a new goal for chronic myeloid leukemia (CML). In clinical practice, tyrosine kinase inhibitor (TKI) dose reductions can be considered a means of preventing adverse effects and improving quality of life. We hypothesized that administration of low-dose TKIs before treatment discontinuation does not impair TFR in patients with CML who have a deep molecular response (DMR, ≥MR4 ). METHODS We conducted a retrospective analysis of 77 patients with CML who discontinued treatment with TKIs. Twenty-six patients had been managed with low-dose TKIs before stopping treatment. Patients were to be exposed to TKIs for ≥5 years and to low-dose TKIs for ≥1 year and in DMR for ≥2 years. The loss of major molecular response (MMR) was considered a trigger for restarting therapy. RESULTS In the low-dose group, 61.5% of patients received second-generation TKIs, and dose reduction was ≥50% for 65.4% of patients. With a median follow-up of 61.5 months, TFR at 12 months was 56.8% in the full-dose TKI group and 80.8% in the low-dose group, and TFR at 60 months was 47.5% and 58.8%, respectively. The median time to molecular recurrence (≥MMR) from TKI discontinuation in the entire cohort was 6.2 months. All patients quickly achieved MMR after resuming TKI therapy. Results appear independent of both dose reduction and potential pretreatment with interferon-α. CONCLUSION This retrospective study shows that TFR was not impaired by low-dose TKI regimens before TKI cessation in Patients with CML. Nevertheless, prospective randomized clinical trials must be undertaken to analyze the probability of successful TFR in patients managed with TKI dose de-escalation strategies before TKI discontinuation.
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Affiliation(s)
- Emilie Cayssials
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France.,INSERM CIC 1402, CHU Poitiers, Poitiers, France.,INSERM 1082, Poitiers, France
| | - Jose Torregrosa-Diaz
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France.,INSERM CIC 1402, CHU Poitiers, Poitiers, France
| | - Pilar Gallego-Hernanz
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France
| | | | - Thomas Systchenko
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France
| | - Natacha Maillard
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France
| | - Déborah Desmier
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France
| | - Antoine Machet
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France
| | - Emmanuel Fleck
- Service d'Oncologie Hématologique, CH La Rochelle, La Rochelle, France
| | - Anne Corby
- Service d'Oncologie Hématologique, CH La Rochelle, La Rochelle, France
| | | | | | | | | | - Lydia Roy
- Service Clinique d'Hématologie, Hôpital Henri-Mondor, Creteil, France
| | | | - Xavier Leleu
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU Poitiers, Poitiers, France.,INSERM CIC 1402, CHU Poitiers, Poitiers, France
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