Treatment-Free Remission in Chronic Myeloid Leukemia: Can We Identify Prognostic Factors?

Saifullah, Hilbeen Hisham and Lucas, Claire Marie ORCID: 0000-0001-6674-7535 (2021) Treatment-Free Remission in Chronic Myeloid Leukemia: Can We Identify Prognostic Factors? CANCERS, 13 (16). 4175-.

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Official URL: http://dx.doi.org/10.3390/cancers13164175

Abstract

Following the development of tyrosine kinase inhibitors (TKI), the survival of patients with chronic myeloid leukaemia (CML) drastically improved. With the introduction of these agents, CML is now considered a chronic disease for some patients. Taking into consideration the side effects, toxicity, and high cost, discontinuing TKI became a goal for patients with chronic phase CML. Patients who achieved deep molecular response (DMR) and discontinued TKI, remained in treatment-free remission (TFR). Currently, the data from the published literature demonstrate that 40-60% of patients achieve TFR, with relapses occurring within the first six months. In addition, almost all patients who relapsed regained a molecular response upon retreatment, indicating TKI discontinuation is safe. However, there is still a gap in understanding the mechanisms behind TFR, and whether there are prognostic factors that can predict the best candidates who qualify for TKI discontinuation with a view to keeping them in TFR. Furthermore, the information about a second TFR attempt and the role of gradual de-escalation of TKI before complete cessation is limited. This review highlights the factors predicting success or failure of TFR. In addition, it examines the feasibility of a second TFR attempt after the failure of the first one, and the current guidelines concerning TFR in clinical practice.

Item Type:	Article
Uncontrolled Keywords:	chronic myeloid leukemia, chronic phase, tyrosine kinase inhibitor, treatment-free remission, TFR deep molecular response, BCR-ABL
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	18 Oct 2022 15:21
Last Modified:	18 Jan 2023 19:49
DOI:	10.3390/cancers13164175
Open Access URL:	https://www.mdpi.com/2072-6694/13/16/4175
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3165628