Introduction. Tyrosine kinase inhibitors (TKIs) discontinuation in patients with chronic myeloid leukemia (CML) is associated with equivocal outcomes related to the withdrawal effects and maintenance of complete hematological and molecular responses.
The objective of the study was the assessment of short- and long-term results of treatment discontinuation in CML patients with deep molecular responses (DMR).
Materials and methods. The observational and cohort study enrolled 23 patients aged 29–73 years, with a chronic phase of CML, managed in the Institute of Oncology Chisinau (Republic of Moldova), between 2016–2022. The real-time polymerase chain reaction (RT-PCR) was used to determine the expression of the BCR/ABL1 transcripts. CML patients agreed and applied for discontinuation of TKIs treatment after the achievement of DMR.
Results. DMR, and especially complete molecular responses (CMR), were achieved in 15 (65.2%) cases under imatinib therapy and in 8 (34.8%) cases under therapy with second generation TKIs. The therapy with TKIs was stopped after the achievement of CMR. Two (8.7%) patients discontinued the TKIs treatment because of pregnancy. The patients did not experience any withdrawal symptoms. The minor molecular relapses developed in 7 (30.4%) patients. The initial BCR-ABL1 p210 transcript expression exceeded 50% in patients with molecular relapses. CMR ranged between 6-26 months prior to the treatment discontinuation in the relapsed patients. The average CMR span (36.1 months) was much shorter (p<0.05) than in patients without molecular relapses (56.4 months).
Conclusions. The discontinuation of TKIs therapy may be a promising healthcare option in CML patients with early chronic phase, long-lasting CMR, low initial expression of BCR/ABL1 p210 transcript and in cases of absence of BCR/ABL1 p190 transcript.
Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, deep molecular responses, treatment discontinuation, minor molecular relapses.
Full text sources https://doi.org/10.31688/ABMU.2023.58.1.06
How to cite
Email to Author
Address for correspondence:
Vasile MUSTEATA
Discipline of Hematology, Institute of Oncology, Chisinau, Republic of
Moldova
Address: Nicolae Testemitanu str. no. 30, Chisinau, Republic of Moldova,
MD-2025
E-mail: vasile.musteata@usmf.md; Phone +373 79516841
