Observational study of chronic myeloid leukemia Italian patients who discontinued tyrosine kinase inhibitors in clinical practice.

Carmen Fava, Giovanna Rege-Cambrin, Irene Dogliotti, Marco Cerrano, Paola Berchialla, Matteo Dragani, Gianantonio Rosti, Fausto Castagnetti, Gabriele Gugliotta, Bruno Martino, Carlo Gambacorti-Passerini, Elisabetta Abruzzese, Chiara Elena, Patrizia Pregno, Antonella Gozzini, Isabella Capodanno, Micaela Bergamaschi, Monica Crugnola, Monica Bocchia, Sara GalimbertiDavide Rapezzi, Alessandra Iurlo, Daniele Cattaneo, Roberto Latagliata, Massimo Breccia, Michele Cedrone, Marco Santoro, Mario Annunziata, Luciano Levato, Fabio Stagno, Francesco Cavazzini, Nicola Sgherza, Valentina Giai, Luigia Luciano, Sabina Russo, Pellegrino Musto, Giovanni Caocci, Federica Sora', Francesco Iuliano, Francesca Lunghi, Giorgina Specchia, Fabrizio Pane, Dario Ferrero, Michele Baccarani, Giuseppe Saglio

Risultato della ricerca: Contributo in rivistaArticolo in rivista

25 Citazioni (Scopus)

Abstract

It is judged safe to discontinue treatment with tyrosine kinase inhibitors for chronic myeloid leukemia in experimental trials on treatment free remission. We collected a total of 293 Italian patients with chronic phase chronic myeloid leukemia who discontinued tyrosine kinase inhibitors in deep molecular response. 72% of patients were on treatment with imatinib, 28% with second generation tyrosine kinase inhibitors at the time of discontinuation. Median duration of treatment with the last tyrosine kinase inhibitor was 77 months (IQR 54;111), median duration of deep molecular response was 46 months (IQR 31;74). Duration of treatment with tyrosine kinase inhibitors and duration of deep molecular response were shorter with 2nd generation tyrosine kinase inhibitors than with imatinib (p<0.001). 88% of the Italian patients discontinued per clinical practice and reasons for stopping treatment were: toxicity for 20% of patients, pregnancy for 6% patients and shared decision between treating physician and patient for 62% of cases. After a median follow-up of 34 months (Min-Max 12-161) overall estimated treatment free remission was 62% (95% CI 56;68). At 12 months treatment free remission was 68% (95% CI 62;74) for imatinib, 73% (95% CI 64;83) for 2nd generation tyrosine kinase inhibitors. Overall median time to restart treatment was 6 months (IQR 4;11). No progressions occurred. Although our study has the limitation of a retrospective study, our experience within the Italian population confirms that discontinuation of imatinib and 2nd generation tyrosine kinase inhibitors is feasible and safe in the clinical practice
Lingua originaleEnglish
pagine (da-a)1589-1596
Numero di pagine4
RivistaHaematologica
Volume104
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • inglese

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