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Review
. 2023 Apr 30;58(S1):S58-S65.
doi: 10.5045/br.2023.2023035. Epub 2023 Apr 7.

Treatment-free remission after discontinuation of imatinib, dasatinib, and nilotinib in patients with chronic myeloid leukemia

Jae Joon Han  1
Affiliations
Review

Treatment-free remission after discontinuation of imatinib, dasatinib, and nilotinib in patients with chronic myeloid leukemia

Jae Joon Han. Blood Res. .

Abstract

Patients with chronic myeloid leukemia (CML) in the chronic phase receiving tyrosine kinase inhibitor (TKI) therapy are expected to have long-term survival outcomes comparable to those of the general population. Many clinical trials have confirmed that some patients sustain molecular responses without continuing TKI therapy. Treatment-free remission (TFR) is a new goal in treating chronic CML. The safety and outcome of TFR were studied in clinical trials after discontinuing imatinib or the second-generation TKIs dasatinib or nilotinib. TFR was safe in approximately 50% of patients who achieved a deep molecular response to TKI therapy. Patients who relapsed after discontinuing TKI responded immediately to the reintroduction of TKI. The mechanism by which TFR increases the success rate still needs to be understood. The hypothesis that the modulation of immune function and targeting of leukemic stem cells could improve the TFR is under investigation. Despite the remaining questions, the TFR has become a routine consideration for clinicians in the practice of molecular remission in patients with CML.

Keywords: Chronic myeloid leukemia; Dasatinib; Imatinib; Nilotinib; Treatment-free remission; Tyrosine kinase inhibitor.

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Conflict of interest statement

Authors’ Disclosures of Potential Conflicts of Interest

No potential conflicts of interest relevant to this article were reported.

References

    1. Park EH, Lee H, Won YJ, et al. Nationwide statistical analysis of myeloid malignancies in Korea: incidence and survival rate from 1999 to 2012. Blood Res. 2015;50:204–17. doi: 10.5045/br.2015.50.4.204. - DOI - PMC - PubMed
    1. Hehlmann R. Innovation in hematology. Perspectives: CML 2016. Haematologica. 2016;101:657–9. doi: 10.3324/haematol.2016.142877. - DOI - PMC - PubMed
    1. Goldman J, Gordon M. Why do chronic myelogenous leukemia stem cells survive allogeneic stem cell transplantation or imatinib: does it really matter? Leuk Lymphoma. 2006;47:1–7. doi: 10.1080/10428190500407996. - DOI - PubMed
    1. Arpinati M, Tolomelli G, Bochicchio MT, et al. Molecular monitoring of BCR-ABL transcripts after allogeneic stem cell transplantation for chronic myeloid leukemia. Biol Blood Marrow Transplant. 2013;19:735–40. doi: 10.1016/j.bbmt.2013.01.007. - DOI - PubMed
    1. Kaeda J, O'Shea D, Szydlo RM, et al. Serial measurement of BCR-ABL transcripts in the peripheral blood after allogeneic stem cell transplantation for chronic myeloid leukemia: an attempt to define patients who may not require further therapy. Blood. 2006;107:4171–6. doi: 10.1182/blood-2005-08-3320. - DOI - PMC - PubMed