Managing chronic myeloid leukemia for treatment-free remission: a proposal from the GIMEMA CML WP

Simona Sica, Michele Baccarani, Elisabetta Abruzzese, Vincenzo Accurso, Francesco Albano, Mario Annunziata, Sara Barulli, Germana Beltrami, Micaela Bergamaschi, Gianni Binotto, Monica Bocchia, Giovanni Caocci, Isabella Capodanno, Francesco Cavazzini, Michele Cedrone, Marco Cerrano, Monica Crugnola, Mariella D'Adda, Chiara Elena, Carmen FavaPaola Fazi, Claudio Fozza, Sara Galimberti, Valentina Giai, Antonella Gozzini, Gabriele Gugliotta, Alessandra Iurlo, Gaetano La Barba, Luciano Levato, Alessandro Lucchesi, Luigia Luciano, Francesca Lunghi, Monia Lunghi, Michele Malagola, Roberto Marasca, Bruno Martino, Angela Melpignano, Maria Cristina Miggiano, Enrico Montefusco, Caterina Musolino, Fausto Palmieri, Patrizia Pregno, Davide Rapezzi, Giovanna Rege-Cambrin, Serena Rupoli, Marzia Salvucci, Rosaria Sancetta, Raffaele Spadano, Fabio Stagno, Mario Tiribelli, Simona Tomassetti, Elena Trabacchi, Massimiliano Bonifacio, Massimo Breccia, Fausto Castagnetti, Fabrizio Pane, Domenico Russo, Giuseppe Saglio, Simona Soverini, Paolo Vigneri, Gianantonio Rosti

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23 Citations (Scopus)

Abstract

Several papers authored by international experts have proposed recommendations on the management of BCR-ABL1+ chronic myeloid leukemia (CML). Following these recommendations, survival of CML patients has become very close to normal. The next, ambitious, step is to bring as many patients as possible into a condition of treatment-free remission (TFR). The Gruppo Italiano Malattie EMatologiche dell’Adulto (GIMEMA; Italian Group for Hematologic Diseases of the Adult) CML Working Party (WP) has developed a project aimed at selecting the treatment policies that may increase the probability of TFR, taking into account 4 variables: the need for TFR, the tyrosine kinase inhibitors (TKIs), the characteristics of leukemia, and the patient. A Delphi-like method was used to reach a consensus among the representatives of 50 centers of the CML WP. A consensus was reached on the assessment of disease risk (EUTOS Long Term Survival [ELTS] score), on the definition of the most appropriate age boundaries for the choice of first-line treatment, on the choice of the TKI for first-line treatment, and on the definition of the responses that do not require a change of the TKI (BCR-ABL1 ≤10% at 3 months, ≤1% at 6 months, ≤0.1% at 12 months, ≤0.01% at 24 months), and of the responses that require a change of the TKI, when the goal is TFR (BCR-ABL1 >10% at 3 and 6 months, >1% at 12 months, and >0.1% at 24 months). These suggestions may help optimize the treatment strategy for TFR
Original languageEnglish
Pages (from-to)4280-4290
Number of pages11
JournalBLOOD ADVANCES
DOIs
Publication statusPublished - 2019

Keywords

  • treatment in chronic phase chronic myeloid leukemia

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