title: Retrospective analysis of clinical outcomes of the patients with chronic myeloid leukemia who stopped administration of tyrosine kinase inhibitors: a single institution experience.
abstract: We describe herein the clinical outcomes of 16 patients with chronic myeloid leukemia in the chronic phase who stopped the administration of tyrosine kinase inhibitors (TKI) after maintaining undetectable levels of major BCR-ABL1, based on real-time quantitative polymerase chain reaction, for prolonged periods (undetectable MR for a median of 2,100 days (822-4,068). The reasons for discontinuing TKI were enrollments in a clinical trial testing discontinuation of these agents (n=9), adverse effects (n=2) or financial problems (n=5). After TKI discontinuation, patients were followed for a median of 551 days (154-2,446). A total of 8 patients (50%) experienced molecular relapse after a median of 119 days (28-171). Among them, 6 patients who lost major molecular response (MMR) were treated with imatinib (n=2) or dasatinib (n=4), while 2 patients who lost undetectable MR after discontinuing TKI (1 each had taken bostinib and imatinib) but maintained MMR were carefully monitored without re-administration of TKI. Of 6 patients who re-started TKI, 4 (67%) achieved undetectable MR but the other 2 achieved only MMR. The results of this small, retrospective study may support the current understanding of treatment discontinuation, possibly leading to a sustained deep molecular response in some patients.
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Senoo
authors.forename: Kosuke
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kaito
authors.forename: Shuhei
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Kaito
authors.initials: K
authors.lastname: Harada
authors.forename: Keita
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hino
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Ikegawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watanabe
authors.forename: Kyoko
authors.initials: K
authors.lastname: Watakabe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hagino
authors.forename: Aiko
authors.initials: A
authors.lastname: Igarashi
authors.forename: Yuho
authors.initials: Y
authors.lastname: Najima
authors.forename: Noriko
authors.initials: N
authors.lastname: Doki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kakihana
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057239:Early Termination of Clinical Trials; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors