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Review
. 2017 Oct;12(5):415-423.
doi: 10.1007/s11899-017-0404-z.

Chronic Myeloid Leukemia-the Promise of Tyrosine Kinase Inhibitor Discontinuation

Ravi Kishore Narra  1 , Kathryn E Flynn  2 , Ehab Atallah  3
Affiliations
Review

Chronic Myeloid Leukemia-the Promise of Tyrosine Kinase Inhibitor Discontinuation

Ravi Kishore Narra et al. Curr Hematol Malig Rep. 2017 Oct.

Abstract

Some believe that tyrosine kinase inhibitor (TKI) therapy is as close to perfect as it gets in oncologic therapy. Patients diagnosed with chronic myeloid leukemia (CML) are treated with a daily oral therapy, through which most achieve remission. TKI therapy is not associated with classic chemotherapy side effects, and most patients are able to resume their normal activities of daily living. Moreover, recent data has demonstrated that CML does not affect the life expectancy of patients whose disease is well controlled with a TKI. However, TKI therapy is actually not that perfect. Patients need to stay on therapy forever. They have to remember to take their medications daily. TKIs are expensive, and the financial burden to patient and society cannot be overstated. Most patients' health-related quality of life is affected; common side effects include fatigue, muscle cramps, pain, edema, skin problems, and gastrointestinal symptoms. In addition, concerns about long-term side effects remain. Recently several studies have shown the feasibility and safety of discontinuation in a select group of patients. Herein, we will review the currently available data on stopping TKIs in CML.

Keywords: Chronic myeloid leukemia; Costs of therapy; Quality of life; TKI stop studies; Treatment-free remission; Tyrosine kinase inhibitor discontinuation.

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Conflict of interest statement

Conflict of Interest

Ravi Kishore Narra and Kathryn E. Flynn each declare no potential conflicts of interest. Ehab Atallah reports personal fees from BMS, personal fees from Novartis, personal fees from Pfizer, and personal fees from Ariad outside the submitted work.

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