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Treatment-Free Remission in CML: the US Perspective
Guru Subramanian Guru Murthy1, Ehab Atallah2
1Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA. gmurthy@mcw.edu.
Current Hematologic Malignancy Reports
|January 16, 2019
Summary
Chronic myeloid leukemia (CML) patients can now aim to stop tyrosine kinase inhibitor (TKI) therapy. Achieving deep molecular response makes TKI cessation feasible, with ongoing research to improve treatment-free remission (TFR) success.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Chronic myeloid leukemia (CML) management has evolved with tyrosine kinase inhibitors (TKIs), offering near-normal life expectancy.
- Lifelong TKI therapy presents challenges including reduced quality of life and economic burden for CML patients.
- Current CML management trends focus on TKI cessation strategies.
Purpose of the Study:
- To review the feasibility and safety of TKI discontinuation in CML.
- To explore the shift in CML management towards treatment-free remission (TFR).
- To discuss the current understanding and future directions for TKI cessation in CML.
Main Methods:
- Review of recent clinical studies and practice guidelines on TKI discontinuation for CML.
- Analysis of factors influencing successful TKI cessation and sustained treatment-free remission (TFR).
Main Results:
- TKI discontinuation is feasible and safe in selected CML patients with deep and sustained molecular response.
- TKI cessation has been integrated into clinical practice, though biological factors for success vary.
- Research is ongoing to optimize strategies for maintaining TFR and increasing patient eligibility.
Conclusions:
- TKI cessation represents a significant advancement in CML management, improving patient quality of life.
- Further research is needed to elucidate the biology of successful TKI cessation and enhance TFR rates.
- Optimizing TFR strategies is crucial for a growing number of CML patients.
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