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. 2022 May;101(5):1015-1022.
doi: 10.1007/s00277-022-04779-x. Epub 2022 Mar 12.

Discontinuation of tyrosine kinase inhibitor in chronic myeloid leukemia: a retrospective cohort in east occitania

J B Robin  1   2 , A Theron  3 , P Quittet  4   5 , C Exbrayat  6 , J B Gaillard  4   7 , T Lavabre-Bertrand  4   8 , S David  9 , A Saad  10 , E Jourdan  4   11 , G Cartron  4   5
Affiliations

Discontinuation of tyrosine kinase inhibitor in chronic myeloid leukemia: a retrospective cohort in east occitania

J B Robin et al. Ann Hematol. 2022 May.

Abstract

Tyrosine kinase inhibitor (TKI) discontinuation in chronic phase chronic myeloid leukemia (CML) patients has been examined in a real-life setting in the east occitania region of France. We have collected sex, age, prognostic scores, pre-TKI treatment, TKI length and response, relapse data from patients who had stopped TKI in prolonged complete molecular remission (CMR), and analyzed relapse risk factors. Sixty consecutive patients were included from january 2010 to december 2016. Sixteen received pre-TKI treatment. Fifty-three received a first-generation TKI, and seven had a second-generation TKI in first-line therapy. The median TKI time to achieve CMR was 20.5 months [5-137]. The median TKI length before discontinuation treatment was 73 months [12-158]. Twenty-two patients (37%) relapsed with a median time to relapse of 6 months [3-27]. An intermediate or high Sokal score was the only relapse risk factor (HR = 3.32, p < 0.05) associated with relapse after TKI discontinuation. TKI discontinuation was possible without relapse for half of the patients in chronic phase CML. In a real-life cohort, a high-risk Sokal score at diagnosis appears to be an adverse prognosis feature for TKI discontinuation.

Keywords: Chronic myeloid leukemia; Complete molecular response; Molecular recurrence-free remission; Tyrosine kinase inhibitor.

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