Second Treatment-Free Remission Attempt in Patients with Chronic Myeloid Leukemia
Clinical Lymphoma Myeloma and Leukemia Volume 24 Issue 4
Page e138-e141
published_at 2023-12-29
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| File | |
| Title ( eng ) |
Second Treatment-Free Remission Attempt in Patients with Chronic Myeloid Leukemia
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| Creator |
Kamachi Kazuharu
Kimura Shinya
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| Source Title |
Clinical Lymphoma Myeloma and Leukemia
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| Volume | 24 |
| Issue | 4 |
| Start Page | e138 |
| End Page | e141 |
| Abstract |
Long-term survival outcomes of patients with chronic myeloid leukemia in the chronic phase are now similar to those of the general population, following the introduction of ABL1 tyrosine kinase inhibitors (TKIs). Approximately 40% to 80% of patients with chronic myeloid leukemia successfully achieved treatment-free remission after the first attempt of TKI discontinuation (TFR1), after achieving a durable deep molecular response. However, the possibility of achieving treatment-free remission after a second attempt of TKI discontinuation (TFR2) remains unclear. Therefore, we reviewed current TFR2 studies to clarify the feasibility of achieving TFR2. We identified 5 TFR2 clinical trials and 2 real-world reports. TFR2 attempt may be feasible after retreatment with imatinib, nilotinib, or dasatinib. Patients who have achieved MR4.0 or deeper durable molecular remission are eligible to enter the TFR2 phase. Imatinib is well tolerated and can be administered for consolidative treatment before the TFR2 attempt, whereas drug-related adverse effects of nilotinib or dasatinib affect their tolerability and might lead to discontinuation. Late onset relapse (> 1 year or > 2 year) was often reported, thus careful monitoring is needed.
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| Keywords |
Dasatinib
Imatinib
Nilotinib
Second attempt TFR (TFR2)
Treatment free remission (TFR)
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| Descriptions |
This work was partially supported by research grants from the Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research (21K16245 to H.U.), and the Shinnihon Foundation of Advanced Medical Treatment Research (H.U.), Takeda Science Foundation (H.U.), the Medical Research Encouragement Prize of The Japan Medical Association (H.U.), the Japanese society of hematology research grant (H.U.) and Japanese foundation for multidisciplinary treatment of cancer (H.U.).
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| Language |
eng
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| Resource Type | journal article |
| Publisher |
Elsevier
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| Date of Issued | 2023-12-29 |
| Rights |
© 2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
This is not the published version. Please cite only the published version.
この論文は出版社版ではありません。引用の際には出版社版をご確認、ご利用ください。
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| Publish Type | Accepted Manuscript |
| Access Rights | open access |
| Source Identifier |
[DOI] https://doi.org/10.1016/j.clml.2023.12.011
isVersionOf
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| 助成機関名 |
日本学術振興会
Japan Society for the Promotion of Science
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| 助成機関識別子 |
[Crossref Funder] https://doi.org/10.13039/501100001691
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| 研究課題名 |
新規DNAメチル化阻害剤を用いたCML幹細胞を標的とした治療戦略
Treatment strategy for elimination of CML stem cell using novel DNMT inhibitor
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| 研究課題番号 |
21K16245
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