Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution

Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop...
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Autor*in:	Cerveira, Nuno [verfasserIn] Loureiro, Bruno Bizarro, Susana Correia, Cecília Torres, Lurdes Lisboa, Susana Vieira, Joana Santos, Rui Pereira, Dulcineia Moreira, Cláudia Chacim, Sérgio Domingues, Nélson Espírito-Santo, Ana Oliveira, Isabel Moreira, Ilídia Viterbo, Luísa Martins, Ângelo Teixeira, Manuel R. Mariz, José M.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Chronic myeloid leukemia TKI discontinuation TKI therapy duration Sustained deep molecular response Unsustained deep molecular response

Anmerkung:	© The Author(s). 2018

Übergeordnetes Werk:	Enthalten in: BMC cancer - London : BioMed Central, 2001, 18(2018), 1 vom: 12. Dez.
Übergeordnetes Werk:	volume:18 ; year:2018 ; number:1 ; day:12 ; month:12

Links:	Volltext

DOI / URN:	10.1186/s12885-018-5167-y

Katalog-ID:	SPR027707318

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520			\|a Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration.
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700	1		\|a Teixeira, Manuel R. \|4 aut
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allfields	10.1186/s12885-018-5167-y doi (DE-627)SPR027707318 (SPR)s12885-018-5167-y-e DE-627 ger DE-627 rakwb eng Cerveira, Nuno verfasserin (orcid)0000-0001-5098-3840 aut Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. Chronic myeloid leukemia (dpeaa)DE-He213 TKI discontinuation (dpeaa)DE-He213 TKI therapy duration (dpeaa)DE-He213 Sustained deep molecular response (dpeaa)DE-He213 Unsustained deep molecular response (dpeaa)DE-He213 Loureiro, Bruno aut Bizarro, Susana aut Correia, Cecília aut Torres, Lurdes aut Lisboa, Susana aut Vieira, Joana aut Santos, Rui aut Pereira, Dulcineia aut Moreira, Cláudia aut Chacim, Sérgio aut Domingues, Nélson aut Espírito-Santo, Ana aut Oliveira, Isabel aut Moreira, Ilídia aut Viterbo, Luísa aut Martins, Ângelo aut Teixeira, Manuel R. aut Mariz, José M. aut Enthalten in BMC cancer London : BioMed Central, 2001 18(2018), 1 vom: 12. Dez. (DE-627)326643710 (DE-600)2041352-X 1471-2407 nnns volume:18 year:2018 number:1 day:12 month:12 https://dx.doi.org/10.1186/s12885-018-5167-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2018 1 12 12
spelling	10.1186/s12885-018-5167-y doi (DE-627)SPR027707318 (SPR)s12885-018-5167-y-e DE-627 ger DE-627 rakwb eng Cerveira, Nuno verfasserin (orcid)0000-0001-5098-3840 aut Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. Chronic myeloid leukemia (dpeaa)DE-He213 TKI discontinuation (dpeaa)DE-He213 TKI therapy duration (dpeaa)DE-He213 Sustained deep molecular response (dpeaa)DE-He213 Unsustained deep molecular response (dpeaa)DE-He213 Loureiro, Bruno aut Bizarro, Susana aut Correia, Cecília aut Torres, Lurdes aut Lisboa, Susana aut Vieira, Joana aut Santos, Rui aut Pereira, Dulcineia aut Moreira, Cláudia aut Chacim, Sérgio aut Domingues, Nélson aut Espírito-Santo, Ana aut Oliveira, Isabel aut Moreira, Ilídia aut Viterbo, Luísa aut Martins, Ângelo aut Teixeira, Manuel R. aut Mariz, José M. aut Enthalten in BMC cancer London : BioMed Central, 2001 18(2018), 1 vom: 12. Dez. (DE-627)326643710 (DE-600)2041352-X 1471-2407 nnns volume:18 year:2018 number:1 day:12 month:12 https://dx.doi.org/10.1186/s12885-018-5167-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2018 1 12 12
allfields_unstemmed	10.1186/s12885-018-5167-y doi (DE-627)SPR027707318 (SPR)s12885-018-5167-y-e DE-627 ger DE-627 rakwb eng Cerveira, Nuno verfasserin (orcid)0000-0001-5098-3840 aut Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. Chronic myeloid leukemia (dpeaa)DE-He213 TKI discontinuation (dpeaa)DE-He213 TKI therapy duration (dpeaa)DE-He213 Sustained deep molecular response (dpeaa)DE-He213 Unsustained deep molecular response (dpeaa)DE-He213 Loureiro, Bruno aut Bizarro, Susana aut Correia, Cecília aut Torres, Lurdes aut Lisboa, Susana aut Vieira, Joana aut Santos, Rui aut Pereira, Dulcineia aut Moreira, Cláudia aut Chacim, Sérgio aut Domingues, Nélson aut Espírito-Santo, Ana aut Oliveira, Isabel aut Moreira, Ilídia aut Viterbo, Luísa aut Martins, Ângelo aut Teixeira, Manuel R. aut Mariz, José M. aut Enthalten in BMC cancer London : BioMed Central, 2001 18(2018), 1 vom: 12. Dez. (DE-627)326643710 (DE-600)2041352-X 1471-2407 nnns volume:18 year:2018 number:1 day:12 month:12 https://dx.doi.org/10.1186/s12885-018-5167-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2018 1 12 12
allfieldsGer	10.1186/s12885-018-5167-y doi (DE-627)SPR027707318 (SPR)s12885-018-5167-y-e DE-627 ger DE-627 rakwb eng Cerveira, Nuno verfasserin (orcid)0000-0001-5098-3840 aut Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. Chronic myeloid leukemia (dpeaa)DE-He213 TKI discontinuation (dpeaa)DE-He213 TKI therapy duration (dpeaa)DE-He213 Sustained deep molecular response (dpeaa)DE-He213 Unsustained deep molecular response (dpeaa)DE-He213 Loureiro, Bruno aut Bizarro, Susana aut Correia, Cecília aut Torres, Lurdes aut Lisboa, Susana aut Vieira, Joana aut Santos, Rui aut Pereira, Dulcineia aut Moreira, Cláudia aut Chacim, Sérgio aut Domingues, Nélson aut Espírito-Santo, Ana aut Oliveira, Isabel aut Moreira, Ilídia aut Viterbo, Luísa aut Martins, Ângelo aut Teixeira, Manuel R. aut Mariz, José M. aut Enthalten in BMC cancer London : BioMed Central, 2001 18(2018), 1 vom: 12. Dez. (DE-627)326643710 (DE-600)2041352-X 1471-2407 nnns volume:18 year:2018 number:1 day:12 month:12 https://dx.doi.org/10.1186/s12885-018-5167-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2018 1 12 12
allfieldsSound	10.1186/s12885-018-5167-y doi (DE-627)SPR027707318 (SPR)s12885-018-5167-y-e DE-627 ger DE-627 rakwb eng Cerveira, Nuno verfasserin (orcid)0000-0001-5098-3840 aut Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2018 Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. Chronic myeloid leukemia (dpeaa)DE-He213 TKI discontinuation (dpeaa)DE-He213 TKI therapy duration (dpeaa)DE-He213 Sustained deep molecular response (dpeaa)DE-He213 Unsustained deep molecular response (dpeaa)DE-He213 Loureiro, Bruno aut Bizarro, Susana aut Correia, Cecília aut Torres, Lurdes aut Lisboa, Susana aut Vieira, Joana aut Santos, Rui aut Pereira, Dulcineia aut Moreira, Cláudia aut Chacim, Sérgio aut Domingues, Nélson aut Espírito-Santo, Ana aut Oliveira, Isabel aut Moreira, Ilídia aut Viterbo, Luísa aut Martins, Ângelo aut Teixeira, Manuel R. aut Mariz, José M. aut Enthalten in BMC cancer London : BioMed Central, 2001 18(2018), 1 vom: 12. Dez. (DE-627)326643710 (DE-600)2041352-X 1471-2407 nnns volume:18 year:2018 number:1 day:12 month:12 https://dx.doi.org/10.1186/s12885-018-5167-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2018 1 12 12
language	English
source	Enthalten in BMC cancer 18(2018), 1 vom: 12. Dez. volume:18 year:2018 number:1 day:12 month:12
sourceStr	Enthalten in BMC cancer 18(2018), 1 vom: 12. Dez. volume:18 year:2018 number:1 day:12 month:12
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Chronic myeloid leukemia TKI discontinuation TKI therapy duration Sustained deep molecular response Unsustained deep molecular response
isfreeaccess_bool	true
container_title	BMC cancer
authorswithroles_txt_mv	Cerveira, Nuno @@aut@@ Loureiro, Bruno @@aut@@ Bizarro, Susana @@aut@@ Correia, Cecília @@aut@@ Torres, Lurdes @@aut@@ Lisboa, Susana @@aut@@ Vieira, Joana @@aut@@ Santos, Rui @@aut@@ Pereira, Dulcineia @@aut@@ Moreira, Cláudia @@aut@@ Chacim, Sérgio @@aut@@ Domingues, Nélson @@aut@@ Espírito-Santo, Ana @@aut@@ Oliveira, Isabel @@aut@@ Moreira, Ilídia @@aut@@ Viterbo, Luísa @@aut@@ Martins, Ângelo @@aut@@ Teixeira, Manuel R. @@aut@@ Mariz, José M. @@aut@@
publishDateDaySort_date	2018-12-12T00:00:00Z
hierarchy_top_id	326643710
id	SPR027707318
language_de	englisch
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However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. 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author	Cerveira, Nuno
spellingShingle	Cerveira, Nuno misc Chronic myeloid leukemia misc TKI discontinuation misc TKI therapy duration misc Sustained deep molecular response misc Unsustained deep molecular response Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution
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topic_title	Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution Chronic myeloid leukemia (dpeaa)DE-He213 TKI discontinuation (dpeaa)DE-He213 TKI therapy duration (dpeaa)DE-He213 Sustained deep molecular response (dpeaa)DE-He213 Unsustained deep molecular response (dpeaa)DE-He213
topic	misc Chronic myeloid leukemia misc TKI discontinuation misc TKI therapy duration misc Sustained deep molecular response misc Unsustained deep molecular response
topic_unstemmed	misc Chronic myeloid leukemia misc TKI discontinuation misc TKI therapy duration misc Sustained deep molecular response misc Unsustained deep molecular response
topic_browse	misc Chronic myeloid leukemia misc TKI discontinuation misc TKI therapy duration misc Sustained deep molecular response misc Unsustained deep molecular response
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title	Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution
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title_full	Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution
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author_browse	Cerveira, Nuno Loureiro, Bruno Bizarro, Susana Correia, Cecília Torres, Lurdes Lisboa, Susana Vieira, Joana Santos, Rui Pereira, Dulcineia Moreira, Cláudia Chacim, Sérgio Domingues, Nélson Espírito-Santo, Ana Oliveira, Isabel Moreira, Ilídia Viterbo, Luísa Martins, Ângelo Teixeira, Manuel R. Mariz, José M.
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title_sort	discontinuation of tyrosine kinase inhibitors in cml patients in real-world clinical practice at a single institution
title_auth	Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution
abstract	Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. © The Author(s). 2018
abstractGer	Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. © The Author(s). 2018
abstract_unstemmed	Background Most patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) will relapse if treatment is withdrawn, but various trials have recently demonstrated that a significant proportion of patients who achieved a stable and deep molecular response (DMR) can stop therapy without relapsing. However, most information on treatment cessation was obtained from clinical trials with strict recruiting criteria. Methods We evaluated the outcome of 25 patients with CML that discontinued TKI therapy in our institute in real-world clinical practice. Results Of the 25 patients, 76% discontinued therapy in sustained deep molecular response (SDMR) and 24% were in unsustained DMR (UDMR). Discontinuation of therapy due to adverse effects was observed in 5 and 50% of the patients in the SDMR and UDMR groups, respectively. After TKI discontinuation, patients were followed for a median of 24 months. At the time of this analysis, 56% patients had a molecular relapse after a median of 4 months. SDMR and longer treatment duration were associated with lower probability of molecular relapse: 25% in SDMR patients with TKI treatment > 96 months and 85% in UDMR patients with TKI treatment ≤96 months. All relapsed patients promptly resumed TKI therapy and regained at least major molecular response (MMR). Conclusions Our results suggest that TKI discontinuation is safe outside clinical trials and particularly effective in CML patients who are in SDMR with longer TKI treatment duration. © The Author(s). 2018
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title_short	Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution
url	https://dx.doi.org/10.1186/s12885-018-5167-y
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author2	Loureiro, Bruno Bizarro, Susana Correia, Cecília Torres, Lurdes Lisboa, Susana Vieira, Joana Santos, Rui Pereira, Dulcineia Moreira, Cláudia Chacim, Sérgio Domingues, Nélson Espírito-Santo, Ana Oliveira, Isabel Moreira, Ilídia Viterbo, Luísa Martins, Ângelo Teixeira, Manuel R. Mariz, José M.
author2Str	Loureiro, Bruno Bizarro, Susana Correia, Cecília Torres, Lurdes Lisboa, Susana Vieira, Joana Santos, Rui Pereira, Dulcineia Moreira, Cláudia Chacim, Sérgio Domingues, Nélson Espírito-Santo, Ana Oliveira, Isabel Moreira, Ilídia Viterbo, Luísa Martins, Ângelo Teixeira, Manuel R. Mariz, José M.
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Discontinuation of tyrosine kinase inhibitors in CML patients in real-world clinical practice at a single institution

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