title: Safe discontinuation of nilotinib in a patient with chronic myeloid leukemia: a case report.
abstract: BACKGROUND
  Although there is a considerable amount of data in the literature on safe discontinuation of first-generation tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia, little is known about discontinuation of second-generation tyrosine kinase inhibitor therapy. Most previous studies have been focused on dasatinib, and the few cases of nilotinib withdrawal that have been reported had a median follow-up of 12 months. To the best of our knowledge, the present report is the first to describe nilotinib withdrawal with 30 months of follow-up.
  
  
  METHODS
  We report the case of a 64-year-old Caucasian man diagnosed with chronic-phase chronic myeloid leukemia in April 2005. After 4 years of treatment with imatinib, he became intolerant to the drug and was switched to nilotinib. Two years later, he decided to stop nilotinib. Undetectable molecular response persisted for 30 months after discontinuation of the drug.
  
  
  CONCLUSIONS
  Our present case suggests that nilotinib withdrawal is safe for patients with chronic myeloid leukemia who achieve a stable undetectable molecular response. Our patient was homozygous for killer immunoglobulin-like receptor haplotype A, previously reported to be a promising immunogenetic marker for undetectable molecular response. We recommend additional studies to investigate patient immunogenetic profiles and their potential role in complete response to therapy.
authors.affiliation: Bone Marrow Transplant Center, "R Binaghi" Hospital, Via Is Guadazzonis 3, 09126 Cagliari, Italy. giovanni.caocci@unica.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caocci
authors.forename: Marianna
authors.initials: M
authors.lastname: Greco
authors.forename: Giorgio
authors.initials: G
authors.lastname: La Nasa
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use*; D028761:Withholding Treatment
chemical_list: D000970:Antineoplastic Agents; D011743:Pyrimidines; C498826:nilotinib