KEY TAKEAWAYS
- The study aimed to estimate TFR rates after TKI discontinuation in patients with CP-CML.
- The results showed that discontinuing TKI therapy in patients with CP-CML was safe, with over two-thirds achieving TFR.
Discontinuing TKI therapy and achieving treatment-free remission (TFR) have emerged as new objectives for managing chronic-phase chronic myeloid leukemia (CP-CML).
Aamer Aleem and the team aimed to assess the rate of TFR following TKI discontinuation at 3 tertiary care centers.
The study included patients with CP-CML aged 16 years or older who had attempted to discontinue TKI therapy by June 2022. Data collected included patient demographics, prognostic scores, TKI therapy details (type, duration), response and relapse dates, response to TKI re-initiation, and relapse risk factors.
About 55 patients (63.6% female) with a median age of 40 years at diagnosis discontinued TKI therapy. The median duration from diagnosis to TKI discontinuation was 86 months, and the median duration of TKI therapy after achieving deep molecular remission (DMR) was 66 months. With a median follow-up of 34 months, 15 patients (27.3%) relapsed, with a median time to relapse of 5 months.
Most relapses occurred within the first 6 months, except for 3 patients (20%). All relapsed patients achieved major molecular remission (MMR) after restarting TKI therapy, with a median time to MMR of 3 months. Importantly, no patients progressed to advanced-phase CML.
The study demonstrated that discontinuing TKI therapy in CP-CML patients was a feasible and safe strategy in routine clinical practice, leading to TFR in more than two-thirds of carefully selected patients.
This study was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
Source: https://www.clinical-lymphoma-myeloma-leukemia.com/article/S2152-2650(24)00310-0/fulltext
Aleem A, Shaheen NA, Algahtani F, et al. (2024). “Discontinuation of tyrosine kinase inhibitor therapy and treatment-free remission (TFR) in chronic myeloid leukemia: Successful achievement of TFR in more than two-thirds of patients in a real-world practice.” Clin Lymphoma Myeloma Leuk. 2024. doi:10.1016/j.clml.2024.08.006.
